925P - Matched cohort study on patients with cervical cancer diagnosed during pregnancy

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Cancer in Pregnancy
Cervical Cancer
Presenter Frédéric Amant
Citation Annals of Oncology (2014) 25 (suppl_4): iv305-iv326. 10.1093/annonc/mdu338
Authors F. Amant1, C. Uzan2, S.N. Han3, R. Fruscio4, K. Dahl Steffensen5, J. Škultéty6, D. Giuliani7, A. Mephon8, R. Rouzier9, P. Witteveen10, A. Locatelli11, L. Rob12, M.J. Halaska12
  • 1Gynecologic Oncology, University Hospitals Leuven / KU Leuven, 3000 - Leuven/BE
  • 2Surgery, Institut Gustave Roussy, 94805 - Villejuif/FR
  • 3Gynecological Oncology, University Hospitals Leuven/KU Leuven, 3000 - Leuven/BE
  • 4Clinica Ostetrica E Ginecologica, Ospedale San Gerardo, Monza/IT
  • 5Oncology, Vejle Hospital, Vejle/DK
  • 6Gynaecology, 2nd Medical Faculty, Charles University, Prague/CZ
  • 7Clinica Ostetrica E Ginecologica, Ospedale San Gerardo - University of Milan-Bicocca, Monza/IT
  • 8Department Of Surgery, Institut Gustave Roussy, 94805 - Villejuif/FR
  • 9Gynaecological Surgery, Institut Gustave Roussy, Villejuif/FR
  • 10Dept Of Medical Oncology, University Medical Center Utrecht, 3508 GA - Utrecht/NL
  • 11Clinica Ostetrica E Ginecologica, Ospedale San Gerardo-University of Milano-Bicocca, Monza/IT
  • 12Gynaecological Oncology, 2nd Medical Faculty, Charles University, Prague/CZ

Abstract

Aim

Invasive cervical cancer is quite common amongst women of 20 to 40 years of age, with the incidence increasing after 30 years of age. Estimated incidence in Europe is 1,2-12 cases per 100 000 pregnancies. Only few data are available concerning the prognosis of cervical cancer diagnosed during pregnancy. Majority of matched controlled studies included patients with historical treatment strategies. Lately new treatment modalities such as chemotherapy and fertility preserving surgery have been incorporated in the management of such patients. The aim of our study is to compare the prognosis of cervical cancer patients diagnosed during and outside of pregnancy.

Methods

132 patients diagnosed with cervical cancer during pregnancy from 5 European centers have been included from a period 1990-2012. Each center matched its patient with 2 controls by age (± 5 years), stage (IA1, IA2, IB1 less than 2cm, IB1 2-4cm, IB2, IIA, IIB, higher) and primary treatment modality (NAC, surgery, chemoradiotherapy). Information regarding age, histological type, grade, LVSI, stage, size of the tumour, method of diagnosis, place of recurrence, mode of delivery and date of recurrence and death were recorded. Comparison of both groups were tested by chi-sqared test of independence. Survival analysis was performed by Kaplan–Meier product-limit method and compared by the log-rank test.

Results

Average age at diagnosis was 33,8 years, diagnosed at 19th week of pregancy. During pregnancy 13,33%, 0,74%, 46,67%, 18,53% and 19,99% were diagnosed at stages IA1, IA2, IB1, IB2 and higher stages. PFS as well as OS were not statistically significantly different. As a treatment 27% of patients underwent termination of pregnancy followed by standard treatment, 20% were terminated prematurely by Cesarean section, 18,9% delayed their treatment, 17,4% underwent surgical treatment during pregnancy and 16,7% received neoadjuvant chemotherapy. No differences were found comparing abortion, delay and neoadjuvant chemotherapy.

Conclusions

The prognosis of patients diagnosed with cevical cancer during pregnancy is similar to those diagnosed outside of pregnancy.

Disclosure

All authors have declared no conflicts of interest.