THE PROGNOSIS OF CERVICAL-CANCER ASSOCIATED WITH PREGNANCY - A MATCHED COHORT STUDY

Objective: To assess the effect of pregnancy on the prognosis of cervi cal cancer and the morbidity of standard treatment. Methods: We analyz ed 44 women with cervical carcinoma associated with pregnancy, who wer e matched with 44 controls. Matching criteria were age, stage of disea se (according to the International Federation of Gynecology and Obstet rics classification), tumor type, treatment modality, and period of tr eatment. Results: In 23 cases, cervical cancer was diagnosed during pr egnancy and in the other 21 cases, within 6 months after delivery. Thi rty-nine women had early-stage disease (eight IA, 25 IB, and six IIA), and five had advanced stages (four IIB and one IIIB). The overall 5-y ear survival rate was 80% among subjects and 82% among controls, where as the relative risk (RR) of dying within 5 years was 1.12 (95% confid ence interval [CI] 0.48-2.65). With regard to the 5-year survival rate (85% for both subjects and controls, the RR of dying was 1.00 [95% CI 0.35-2.83]); no differences were found between subjects and controls for early-stage cervical carcinoma. The size of the group with advance d-stage cervical carcinoma was too small to allow any statistical anal ysis. No statistically significant differences in survival were observ ed between cases diagnosed during pregnancy and cases diagnosed after delivery. In addition, the mode of delivery had no effect on survival. Early complications within 6 weeks after treatment were seen 33 times in 25 subjects and 29 times in 23 controls. No differences were obser ved in the prevalence and type of early complications in subjects vers us controls. Late complications after 6 weeks of treatment were seen n ine times in nine subjects and 11 times in ten controls. No significan t differences were observed in the prevalence and type of late complic ations in subjects versus controls. Conclusions: The prognosis of earl y-stage cervical cancer is similar in pregnant and nonpregnant patient s when standard treatment is given. Because of the limited number of p atients, no conclusions can be drawn about advanced-stage cervical can cer. The goal should be standard oncologic