SURGICAL-MANAGEMENT OF CERVICAL-CANCER COMPLICATING PREGNANCY - A CASE-CONTROL STUDY

A retrospective, case-control analysis of 30 women with cervical cance r associated with pregnancy, surgically managed at the University of I owa between 1960 and 1994, was performed. Controls were matched with c ases based on age, histology, stage, treatment, and year of treatment. Patients were divided into two groups: Group I, radical hysterectomy (26 patients) and group II, simple hysterectomy (4 patients). Eleven p atients underwent surgical treatment in the third trimester with a mea n planned delay in therapy of 16 weeks. None of the patients with a pl anned delay in therapy developed recurrent disease, No neonatal morbid ity was encountered in these patients. Among group I patients, there w as longer anesthesia time (P <0.03), but there were no differences in the mean operative time, There was more blood loss at the time of surg ery among pregnant patients (1493 cc vs 1065 cc for group I, P=0.005; 812 cc vs 362 cc for group II, P=0.03); however, there was no differen ce in the frequency of blood transfusion, The percentage of patients r eceiving a transfusion decreased significantly after 1991 (33% versus 90%, P=0.01 for pregnant patients and 33% versus 85%, P=0.03 for nonpr egnant patients), There were no differences in the time required for p ost-operative bladder drainage, mean hospital stay, febrile morbidity, incidence of wound infection, wound separation, pelvic abscess, throm boembolic disease, or urinary tract infection, One case patient and 3 control patients died of disease, but this difference was not statisti cally significant, Based upon our data, in selected cases of early-sta ge cervical cancer, surgical management of cervical cancer is safe dur ing pregnancy, For early Stage I squamous cancers, planned delay in th erapy is safe. (C) 1996 Academic Press, Inc.