The course and outcome of pregnancy in the presence of advanced cervical cancer


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Background: Cervical cancer occupies a leading position in the pattern of gynecological cancers. The tumor biological uniqueness during pregnancy is the combination of uncontrolled tumor growth and controlled fetoplacental unit growth in one organism. According to statistics, cancer during pregnancy is quite rare: one case per 1,000 pregnancies. Case report: The authors have presented their own experience in choosing the tactics of follow-up, treatment, and delivery in a patient with stage IV cervical cancer diagnosed in the second trimester of pregnancy. The paper shows the features of the course of the disease, the complexity of pregnancy management, including chemotherapy cycles, as well as the features of delivery and surgical treatment for cervical cancer. It is indicated that for the treatment of cancer during pregnancy, it is necessary to determine and designate the main parameters: the cancer stage, indications for treatment, disease curability, treatment regimens based on modern recommendations, and a multidisciplinary approach to choosing treatment policy. Conclusion: This clinical case clearly demonstrates the need for complex interaction in decision-making in each individual case of physicians of various specialties: a gynecological oncologist, a morphologist, a radiologist, a chemotherapist, an obstetrician, an anesthesiologist/resuscitator, a neonatologist, as well as a psychologist and a lawyer.

Full Text

Restricted Access

About the authors

Alyona L. Chernyshova

Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences

Email: alacher@list.ru
Dr. Med. Sci., Professor of the Russian Academy of Sciences, Leading Researcher at the Department of Gynecology

Larisa A. Folomiets

Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences; Siberian State Medical University, Ministry of Health of Russia

Email: kolomietsla@oncobgy.tomsk.ru
Dr. Med. Sci., Professor

Tatiana V. Ivanova

Siberian State Medical University, Ministry of Health of Russia

Email: itv7@yandex.ru
PhD, Associate Professor

Evgeny A. Usynin

Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences

Dr. Med. Sci., Head of the Department of General Oncology

Sergey G. Afanasyev

Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences

Email: afanasievsg@oncology.tomskru
Dr. Med. Sci., Professor, Head of the Department of Abdominal Oncology

Olga V. Shpileva

Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences

Email: ovshpileva@yandex.ru
Junior Researcher at the Oncology Department No. 4

Olga S. Dil

Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences

Email: dilara@tnimc.ru
Resident Doctor of the Oncology Department No. 4

Andrey A. Li

Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences

Email: lia65@gmail.ru
PhD, Head of the Department of Anesthesiology and Resuscitation

Yuri A. Bochkov

Siberian State Medical University, Ministry of Health of Russia

Email: bua35@mail.ru
Assistant at the Department of Anesthesiology and Resuscitation

Edward V. Devald

Siberian State Medical University, Ministry of Health of Russia

Assistant at the Department of Anesthesiology and Resuscitation

Vitaly A. Antipov

City Clinical Hospital No. 24, Moscow Healthcare Department

Email: vitaly-antipov@yandex.ru
Dr. Med. Sci., Director

Sergey E. Krasilnikov

Academician E.N. Meshalkin National Medical Research Center, Ministry of Health of Russia

Email: krasilnikov_s@meshalkin.ru
Dr. Med. Sci., Professor, Director of the Institute of Oncology

References

  1. GLOBOCAN 2018: Estimated cancer incidence, mortality and prevalence worldwide in 2018. IARC. (Internet).
  2. Серов В.Н., Шмаков Р.Г., Полушкина Е.С., Волочаева М.В. Рак и беременность. РМЖ. Мать и дитя. 2015; 20: 1195-7.
  3. Петрова У.Л., Шмаков Р.Г. Новая коронавирусная инфекция 2019 и беременность: что мы знаем? Акушерство и гинекология. 2022; 2: 4-11. https://dx.doi.org/10.18565/aig.2022.2.4-11.
  4. Ассоциация онкологов России, Российское общество клинической онкологии. Клинические рекомендации. Рак шейки матки. М.; 2018.
  5. Каприн А.Д., Старинский В.В., Петрова Г.В., ред. Злокачественные новообразования в России в 2016 г. (заболеваемость и смертность). М.: МНИОИ им. П.А.Герцена - филиал ФГБУ «НМИЦ радиологии» Минздрава России; 2018. 250с.
  6. Айламазян Э.К., Кулаков В.И., Радзинский В.Е., Савельева Г.М., ред. Национальное руководство. Акушерство. М.: ГЭОТАР-Медиа; 2014. 1200с.
  7. Вербитская Е.А., Урманчеева А.Ф., Артемьева А. С., Михетько А.А., Новик В.И., Берлев И.В., Микая Н.А., Ульрих Е.А. Беременность, ассоциированная с неинвазивным раком шейки матки. Прогноз для матерей и детей. Опухоли женской репродуктивной системы. 2018; 14(3): 71-6. https://dx.doi.org/10.17650/1994-4098-2018-14-3-71-76.
  8. Ульрих Е.А. и др. Опухоли репродуктивных органов в сочетании с беременностью. Практические рекомендации. СПб; 2014. 54с.
  9. Пароконная А.А., ред. Рак и репродукция. М: Галеон; 2012. 208с.
  10. Савельева Г.М., Сухих Г.Т., Серов В.Н., Радзинский В.Е., Манухин И.В., ред. Гинекология. Национальное руководство. М.: ГЭОТАР-Медиа; 2017. 989с.
  11. Jeronimo J., Castle P.E., Temin S., Denny L., Gupta V., Kim J.J. et al. Secondary prevention of cervical cancer: ASCO Resource-Stratified Clinical Practice Guideline. J. Glob. Oncol. 2016; 3(5): 635-57. https://dx.doi.org/10.1200/JGO.2016.006577.
  12. An Advisory Committee Statement (ACS), National Advisory Committee on Immunization (NACI). Updated recommendations on human papillomavirus (HPV) vaccines: 9-valent HPV vaccine 2-dose immunization schedule and the use of HPV vaccines in immunocompromised population. May 2017.
  13. Committee Opinion No. 704: Human papillomavirus vaccination. Obstet. Gynecol. 2017; 129(6): 1. https://dx.doi.org/10.1097/AOG.0000000000002052.
  14. Короленкова Л.И. Цервикальные траэпителиальные неоплазии и ранние формы рака шейки матки: клинико-морфологическая концепция цервикального канцерогенеза. М.; 2017. 300с.
  15. Sekoranja D., Repse Fokter A. Triaging atypical squamous cells-cannot exclude HighGrade squamous intraepithelial lesion with p16/Ki67 dual stain. J. Low. Genit. Tract. Dis. 2017; 21(2): 108-11. https://dx.doi.org/10.1097/LGT.0000000000000297.
  16. Bergeron C., Ikenberg H., Sideri M., Denton K., Bogers J., Schmidt D. et al.; PALMS Study Group. Prospective evaluation of p16/Ki-67 dualstained cytology for managing women with abnormal Papanicolaou cytology: PALMS study results. Cancer Cytopathol. 2015; 123(6): 373-81. https://dx.doi.org/10.1002/cncy.21542.
  17. Chernyshova A., Kolomiets L., Chekalkin T., Chernov V., Sinilkin I., Gunther V. et al. Fertility-sparing surgery using knitted TiNi mesh implants and sentinel lymph nodes: a 10-year experience. J. Invest. Surg. 2021; 34(10): 1110-8. https://dx.doi.org/10.1080/08941939.2020.1745965.
  18. Benhaim Y., Pautier P., Bensaid C., Lhomme C., Haie-Meder C., Morice P. et al. Neoadjuvant chemotherapy for advanced stage cervical cancer in a pregnant patient: report of one case with rapid tumor progression. Eur. J. Obstet. Gynecol. Reprod. Biol. 2018; 136(2): 267-8. https://dx.doi.org/10.1016/j.ejogrb.2006.10.027.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies