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Cervical carcinoma and pregnancy: A national patterns of care study of the American College of Surgeons
Author(s) -
Jones Walter B.,
Shingleton Hugh M.,
Russell Anthony,
Fremgen Amy M.,
Clive Rosemarie E.,
Winchester David P.,
Chmiel Joan S.
Publication year - 1996
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19960415)77:8<1479::aid-cncr9>3.0.co;2-7
Subject(s) - medicine , radiation therapy , surgery , pregnancy , carcinoma , stage (stratigraphy) , cervical carcinoma , cervical cancer , cancer , paleontology , genetics , biology
Abstract BACKGROUND The American College of Surgeons conducted a national patient care and evaluation study of invasive cervical carcinoma in pregnant patients. METHODS Invasive cervical carcinoma was diagnosed in 161 patients who were pregnant at the time of diagnosis. A long term study of 78 patients diagnosed in 1984 was compared with a short term study of 83 patients diagnosed in 1990. RESULTS The mean age of the patients was 31.8 years. Clinical stages were: IA (29%); IB (54%); IIA (6%); IIB (4%); IIIA (0%); IIIB (3%); IV (1%; AND IVB (3%). Thirty‐one percent of patients were diagnosed in the first trimester, 34% in the second, and 35% in the third. A tumor size of 4 cm or larger in diameter was found in 36% of the patients diagnosed in the first trimester, 40% of the patients diagnosed in the second, and 38% of the patients diagnosed in the third. Patients were treated with surgery alone (86), radiotherapy alone (30), or with combination therapy (45). The overall 5‐year survival rate for patients diagnosed in 1984 was 82%. In this group, the 5‐year survival rate for patients diagnosed in the first trimester was 94.6%, in the second, 76.9%, and in the third, 68.9%. Comparing the two time periods, surgical therapy was performed more often by gynecologic oncologists in 1990 (69% vs. 42%), and a greater percentage of patients were diagnosed with a tumor size of 4 cm or larger in diameter (43% vs. 26%) as well as with stage IIB–IVB disease (15% vs. 6.7%). CONCLUSIONS The prognosis of pregnant patients with invasive cervical carcinoma is similar to that for nonpregnant patients. The significant number of patients diagnosed in the second and third trimesters and the frequent finding of large tumors in all trimesters emphasize the need for patient education and early prenatal evaluation, including cervical cytology and biopsy of any clinically abnormal cervix. Cancer 1996; 77:1479‐88.