Pregnancy-associated cancer: A 10-year experience at Mainz University Hospital, Germany
20 September 2018 (online)
Cancer in pregnancy is a rare coexistence. The incidence is approximately 1 in 1000 pregnancies. Although rare, this coincidence is a challenging situation because cancer or its treatment may endanger two lives.
We investigated the occurrence of pregnancy-associated cancer (defined as cancer diagnosed during pregnancy and up to 1 year after delivery) in pregnancies, resulting in a birth (live birth or stillbirth) or an abortion. Case series were reviewed retrospectively. We included 18 women diagnosed with cancer at Mainz university hospital from 2008 to 2017. Collected data comprised demographics, pregnancy characteristics and outcomes, type of cancer, clinical stage and treatment.
We identified 18 patients with pregnancy-associated malignancies. The following tumors were observed: breast cancer, uterine cervix carcinoma, ovarian cancer, leukemia, papillary carcinoma of thyroid, choriocarcinoma, tongue cancer, laryngeal cancer, and colon cancer. The mean age of patients was 34 years and the mean gestational age at diagnosis was 27.3weeks. Surgical treatment was performed on 4 patients, 4 other patients were treated by chemotherapy, and 9 treated by both. The Cesarean section rate was 50% (9 cases).
The diagnosis of cancer during pregnancy can be delayed and the treatment may be a challenging situation. Due to the limited available data, it's difficult to assess the effect of pregnancy on prognosis in malignant tumours. The therapeutic management should be carried out carefully and based on close interdisciplinary collaboration between oncologists, obstetricians, and neonatologists.