CERVICAL-CANCER IN PREGNANCY - REPORTING ON PLANNED DELAY IN THERAPY

Objective: To report our experience with invasive carcinoma of the cer vix during pregnancy, assessing maternal morbidity due to treatment de lay and reporting maternal and fetal outcome. Methods: Twenty-seven pa tients with invasive cervical cancer, who were pregnant at the time of diagnosis or treatment, were identified from review of morbidity and mortality statistics between January 1, 1980 and December 31, 1991. Al l medical records were examined retrospectively. Results: The incidenc e of cervical carcinoma in our population was 1.2 cases per 10,000 pre gnancies. Most patients had stage I lesions. The predominant histologi c cell type was squamous cell carcinoma, followed by adenosquamous car cinoma and adenocarcinoma. Eight patients with stage Ia or lb cervical cancer postponed therapy to optimize fetal outcome, with a mean diagn osis-to-treatment interval of 144 days (range 53-212). Nineteen patien ts elected immediate treatment, with a mean diagnosis-to-treatment int erval of 17 days (range 2-42). Fetal outcome was uniformly good for th e delayed-treatment group. Nine fetal deaths and two neonatal deaths o ccurred in the immediate-treatment group. All patients who delayed the rapy are free of disease after a median follow-up of 23 months. Conclu sion: Deliberate delay of therapy to achieve fetal maturity appears to be a reasonable option for patients with stage I cervical cancer comp licating pregnancy.