Gynecological cancer during pregnancy-From a gyne-oncological perspective

Acta Obstet Gynecol Scand. 2024 Apr;103(4):761-766. doi: 10.1111/aogs.14763. Epub 2024 Jan 6.

Abstract

Gynecological cancer diagnosed during pregnancy requires accurate diagnosis and staging to determine optimal treatment based on gestational age. Cervical and ovarian cancers are the most common and multidisciplinary team collaboration is pivotal. Magnetic resonance imaging and ultrasound can be used without causing fetal harm. In cervical cancer, early-stage treatments can often be delayed until fetal lung maturation and cesarean section is recommended if disease prevails, in combination with a simple/radical hysterectomy and lymphadenectomy. Chemoradiotherapy, the recommended treatment for advanced stages, is not compatible with pregnancy preservation. Most gestational ovarian cancers are diagnosed at an early stage and consist of nonepithelial cancers or borderline tumors. Removal of the affected adnexa during pregnancy is often necessary for diagnosis, though staging can be performed after delivery. In selected cases of advanced cervical and ovarian cancers, neoadjuvant chemotherapy may be an option to allow gestational advancement but only after thorough multidisciplinary discussions and counseling.

Keywords: cervical cancer; endometrial cancer; oncology; ovarian cancer; pregnancy; vulvar cancer.

MeSH terms

  • Cesarean Section
  • Female
  • Genital Neoplasms, Female* / surgery
  • Humans
  • Hysterectomy
  • Lymph Node Excision
  • Neoplasm Staging
  • Ovarian Neoplasms* / pathology
  • Pregnancy
  • Pregnancy Complications, Neoplastic* / diagnostic imaging
  • Pregnancy Complications, Neoplastic* / pathology
  • Pregnancy Complications, Neoplastic* / therapy
  • Uterine Cervical Neoplasms* / pathology