TY - JOUR
T1 - Gynecologic Cancers in Pregnancy: Guidelines of an International Consensus Meeting
AU - Amant, Frédéric
AU - van Calsteren, Kristel
AU - Halaska, Michael J.
AU - Beijnen, Jos
AU - Lagae, Lieven
AU - Hanssens, Myriam
AU - Heyns, Liesbeth
AU - Lannoo, Lore
AU - Ottevanger, Nelleke P.
AU - Vanden Bogaert, Walter
AU - Ungar, Laszlo
AU - Vergote, Ignace
AU - du Bois, Andreas
PY - 2009
Y1 - 2009
N2 - Background: Gynecologic cancer during pregnancy is a special challenge because cancer or its treatment may affect not only the pregnant women in general but directly involve the reproductive tract and fetus. Currently, there are no guidelines on how to deal with this special coincidence. Methods: An international consensus meeting on staging and treatment of gynecological malignancies during pregnancy was organised including a systematic literature search, and interpretation followed by a physical meeting of all participants with intensive discussion. In the absence of large trials and randomized studies, recommendations were based on available literature data and personal experience thus representing a low but best achievable level of evidence. Findings: Randomized trials and prospective Studies on cancer treatment during pregnancy are lacking. Gynecological cancer during pregnancy is a demanding problem, and multidisciplinary expertise should be available. Counseling both parents on the maternal prognosis and fetal risk is needed. When there is a firm desire to continue the pregnancy, gynecological cancer can be treated in selected cases. The staging and treatment should follow the standard approach as much as possible. Guidelines for safe pelvic surgery during pregnancy are presented. Mainly in cervical and ovarian cancer, chemotherapy and an alternative surgical approach need to be considered. Administration of chemotherapy during the second or third trimester may probably not increase the incidence of congenital malformations. Until now, the long-term Outcome of children in utero exposed to oncological treatment modalities is poorly documented, but preterm birth oil its own is associated with cognitive impairment. Delivery should be postponed preferably until after a gestational age of 35 weeks. Interpretation: Further research including international registries for gynecologic cancer in pregnancy is urgently needed. The gathering of both available literature and personal experience allowed only suggesting models for treatment of gynecologic cancer in pregnancy
AB - Background: Gynecologic cancer during pregnancy is a special challenge because cancer or its treatment may affect not only the pregnant women in general but directly involve the reproductive tract and fetus. Currently, there are no guidelines on how to deal with this special coincidence. Methods: An international consensus meeting on staging and treatment of gynecological malignancies during pregnancy was organised including a systematic literature search, and interpretation followed by a physical meeting of all participants with intensive discussion. In the absence of large trials and randomized studies, recommendations were based on available literature data and personal experience thus representing a low but best achievable level of evidence. Findings: Randomized trials and prospective Studies on cancer treatment during pregnancy are lacking. Gynecological cancer during pregnancy is a demanding problem, and multidisciplinary expertise should be available. Counseling both parents on the maternal prognosis and fetal risk is needed. When there is a firm desire to continue the pregnancy, gynecological cancer can be treated in selected cases. The staging and treatment should follow the standard approach as much as possible. Guidelines for safe pelvic surgery during pregnancy are presented. Mainly in cervical and ovarian cancer, chemotherapy and an alternative surgical approach need to be considered. Administration of chemotherapy during the second or third trimester may probably not increase the incidence of congenital malformations. Until now, the long-term Outcome of children in utero exposed to oncological treatment modalities is poorly documented, but preterm birth oil its own is associated with cognitive impairment. Delivery should be postponed preferably until after a gestational age of 35 weeks. Interpretation: Further research including international registries for gynecologic cancer in pregnancy is urgently needed. The gathering of both available literature and personal experience allowed only suggesting models for treatment of gynecologic cancer in pregnancy
U2 - https://doi.org/10.1111/IGC.0b013e3181a1d0ec
DO - https://doi.org/10.1111/IGC.0b013e3181a1d0ec
M3 - Review article
C2 - 19509538
SN - 1048-891X
VL - 19
SP - S1-S12
JO - International journal of gynecological cancer
JF - International journal of gynecological cancer
IS - 1
ER -