PROGNOSIS OF INVASIVE CERVICAL-CARCINOMA IN PREGNANT VERSUS NONPREGNANT PATIENTS

Purpose: To evaluate the prognosis of patients with invasive cervical cancer related to pregnancy and to assess if survival is altered by pr egnancy. Methods: We reviewed 20 patients (mean age 34.7 years) with i nvasive cervical carcinoma diagnosed during pregnancy between 1971 and 1995. This group was compared with 541 non-pregnant controls with inv asive cervical cancer. All patients had had radical surgical treatment . Results: The overall (disease-free) 5-year survival rates of the pre gnant and non-pregnant patients were 74.4% (6/20 died of disease) and 78.2% (128/541), respectively (p=0.58). The survival rate of a matched group of non-pregnant patients younger than 44 years was 74.8% (57/22 0) (p = 0.77). Four of the pregnant patients had FlGO stage IA2, 11 st age In, 1 stage IIA, 3 stage IIB, 1 stage IIIb disease. All 4 pregnant patients with stage IA2 disease survived free of recurrence. The 5-ye ar survival rate of the 11 pregnant patients with stage IB did not dif fer from that of the non-pregnant patients (81.8% [2/11] versus 78.9% [28/126], p=0.65). The pregnant patients with stage II and III disease had a 5-year survival rate of 40% (4/5) and differed from the non-pre gnant patients with 69% (66/94) (p = 0.0027). The 5-year survival rate s of pregnant and non-pregnant patients with negative lymph nodes were 77.8% (2/9) and 83.6% (25/146), respectively (p=0.74). The 5-year sur vival rates of pregnant and non-pregnant patients with positive lymph nodes were 53.6% (4/7) and 56.5% (32/74), respectively (p = 0.53). The re were no differences in survival rates between pregnant and non-preg nant patients according to squamous cell versus adenocarcinoma and cap illary-like space involvement. 4 pregnant patients with stage In delay ed therapy for 13 to 26 weeks and survived free of disease. Only 10 of 15 pregnant patients treated immediately after diagnosis survived. Co nclusions: Our data do not suggest that pregnancy has an adverse effec t on the prognosis of patients with invasive cervical carcinoma. Delay ing treatment until the fetus has achieved lung maturity appears to be a possible option for patients with stage I disease.