| Clinical Review of Cervical Carcinoma in Situ and Invasive Cervical Cancer in Pregnancy. |
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Jong Soo Kim, Yoon Sook Kim, Seung Do Choi, Jae Gun Sunwoo, Dong Han Bae |
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Department of Obstetrics and Gynecology, University of Soonchunhyang, College of Medicine, Soochunhyang University Chonan Hospital, Chonan, Korea. |
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| Abstract |
OBJECTIVE
Cervical cancer is the most common malignancy of the female genital tract in Korea. Recognized prognostic factors include FIGO stage, histologic grade, depth on invasion, primary cancer screening and age. However, prognosis of pregnant woman with cervical cancer is unclear. We reviewed our patients in an attempt to identify the best management options which resulted in long term survival for the mother. METHODS: We retrospectively investigated the results of 11 patients with CIS and cervical cancer in pregnant patients who had been diagnosed and treated at Soonchunhyang University Medical center from January 1990 to December 2002. RESULTS: The age range was 23-41 years. Six patients were CIS and performed LEEP conization during pregnancy. One patient had stage Ia disease and 3 patients had stage Ib with radical hysterectomy after Cesarean section. 4 cases were diagnosed as squamous cell cancer. One patient with stage Ib had been referred to our hospital at 28 gestational weeks. Another one patient with high risk histology (mucinous adenocarcinoma) pointed out polypectomy at 26 gestational weeks. One year later, the case died after treatment. All of 11 patients were treated surgically and two patients achieved pregnancy again with three live births. Preterm delivery after conization occured in one case at 34 gestational weeks. HPV infection was diagnosed in 82% of patients. The HPV type 16 was infected 4 patients, type 18 was one patient, type 58 was one patient, and mixed another type were 2 patients. CONCLUSION: We conclude that all pregnant women should have a Pap smear performed antenatally. Cone biopsy can be safely performed in pregnant women and may be adequate treatment for CIS. When cervical cancer complicates with pregnancy, decisions, management must include maternal and fetal consideration. |
| Key Words:
Cervical carcinoma in situ, Cervical cancer, Pregnancy |
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