Support for down-staging of pregnancy-associated cervical cancer
| Autor: | Anders Norström, Thomas Rådberg, Erik Holmberg, Cecilia Kärrberg |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
medicine.medical_specialty Adenosquamous carcinoma Population Uterine Cervical Neoplasms Adenocarcinoma Hysterectomy Carcinoma Adenosquamous Pregnancy medicine Atypia Humans Vaginal bleeding Neoplasm Invasiveness Registries education Neoplasm Staging Retrospective Studies Cervical cancer Gynecology Sweden education.field_of_study business.industry Cesarean Section Incidence Pregnancy Outcome Obstetrics and Gynecology Cancer General Medicine Cervical Atypia medicine.disease Colposcopy Carcinoma Squamous Cell Female medicine.symptom business Pregnancy Complications Neoplastic |
| Zdroj: | Acta obstetricia et gynecologica Scandinavica. 94(6) |
| ISSN: | 1600-0412 |
| Popis: | Objective To evaluate all cases of cervical cancer associated with pregnancy during 16 years in the Western Region of Sweden. Design Retrospective, descriptive cohort study. Setting and population All women with cervical cancer, diagnosed during pregnancy or within 6 months after parturition, between 1993 and 2008. Methods The study was based on data from different registers and medical records. Main outcome measures Incidence, diagnostic measures, treatment and outcome of disease. Results Cervical cancer was diagnosed in 47 women (15.6/100 000 deliveries). Sixteen women had abnormal vaginal bleeding and/or discharge. The other women were asymptomatic and diagnosed by abnormal cervical smear or clinical signs at vaginal examination. Nine women had atypical squamous cells of uncertain significance as presenting by cervical atypia. Twenty-two women had stage IA, 17 stage IB1, six stage IB2 and two stage IIA cancer. Cancer was diagnosed in the first trimester in two, in the second trimester in 14, in the third trimester in five and postpartum in 26 women. Histology revealed squamous cell carcinoma in 36 women, adenocarcinoma in eight, and adenosquamous carcinoma in three. Twenty women underwent cesarean section due to diagnosed or clinically suspected cancer, combined with the Wertheim–Meigs radical hysterectomy in six women. Sixteen women with stage IA1 cancer without signs of vascular invasion underwent conization as definitive therapy. Six women died of the disease. Conclusion Early detection of cervical cytological atypia and proper follow-up during pregnancy led to detection of a high proportion of stage I cancer cases, which could be cured with fertility-sparing therapy. |
| Databáze: | OpenAIRE |
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