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Treatment and clinical outcomes of cervical cancer during pregnancy

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单位: [1]Guangzhou Med Univ, Affiliated Hosp 1, Dept Gynecol & Obstet, Guangzhou 511436, Guangdong, Peoples R China [2]Peoples Hosp Three Gorges Univ, Dept Obstet & Gynecol, Yichang 443000, Peoples R China [3]North Sichuan Med Univ, Nanchong Cent Hosp, Dept Obstet & Gynecol, Nanchong 637000, Peoples R China [4]Southern Med Univ, Nanfang Hosp, Dept Obstet & Gynecol, Guangzhou 510515, Guangdong, Peoples R China [5]Ikazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Canc Biol Res Ctr,Wuhan 430000,Hubei,Peoples R China [6]Southern Med Univ, Sch Basic Med Sci, Dept Immunol, Guangdong Prov Key Lab Proteom, Guangzhou 510515, Guangdong, Peoples R China [7]Xiangyang Hosp, Dept Gynecol & Obstet, 15 Jiefang Rd, Xiangyang 441000, Peoples R China
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关键词: Cervical cancer pregnancy clinicopathologic factor tumor size neoadjuvant chemotherapy (NACT)

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Background: This study aims to investigate clinicopathological factors associated with survival rate and treatment of patients with cervical cancer during pregnancy (CCP). Methods: A total of 92 patients diagnosed CCP were retrospectively reviewed. One patient was from Nanfang Hospital of Southern Medical University, 5 patients were from Tongji Hospital, and 86 patients were from case reports in the PubMed database from 1961 to 2019. Patients and tumor characteristics were evaluated. Kaplan-Meier and Cox regression methods were used to analyze the 5-year disease-specific survival (DSS). Results: Most patients (73 cases) were stage I according to the 2018 International Federation of Gynecology and Obstetrics (FIGO) standards. Twelve patients (13.04%) terminated pregnancy once diagnosed. These patients were diagnosed at the mean gestational age (GA) of 11 +/- 3 weeks, during early pregnancy. For the rest of the patients (80 cases) who continued pregnancy, the mean GA was 35 +/- 2 weeks at delivery. There was a significant difference in survival whether the treatment was performed once diagnosed or not. The 5-year DSS was 75% in adenocarcinoma (AC), 68.5% in squamous cell carcinoma (SCC), and 43.7% in the rare subtype. Among the 38 patients who underwent neoadjuvant chemotherapy (NACT), one patient suffered from spontaneous abortion, and one baby experienced acute myeloid leukemia (AML) exFAB (French-American-British)-M7 subtype and received bone marrow transplantation. Other delivered newborns showed no abnormality or malformation. Cox multi-factorial analysis demonstrated that tumor size (2 cm) was an independent overall survival predictor for CCP patients (P<0.05). Conclusions: Tumor size was an independent prognostic factor of survival in CCP patients. Pregnancy has adverse effects on the prognosis of cervical cancer. Personalized treatment is a priority for CCP patients.

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第一作者单位: [1]Guangzhou Med Univ, Affiliated Hosp 1, Dept Gynecol & Obstet, Guangzhou 511436, Guangdong, Peoples R China [2]Peoples Hosp Three Gorges Univ, Dept Obstet & Gynecol, Yichang 443000, Peoples R China
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