Maternal Outcome Of Planned Delay In Treatment Of Cervical Cancer During Pregnancy To Improve Fetal Maturity (Kgog 1006)

Women with invasive cervical cancer during pregnancy would confront with dilemma regarding therapy and the fate of their unborn child. The aim of this study was to investigate patients with invasive cervical cancer during pregnancy in order to assess maternal outcome after planned treatment delay to improve fetal maturity. Between 1995 and 2003, invasive cervical cancer was diagnosed in 35 pregnant women, at 10 hospitals in Korea. Among them, the medical records of 12 patients, who declined immediate therapy in order to improve fetal outcome, were reviewed retrospectively. Four patients had FIGO stage IA1, 5 patients stage IB1, 1 patient stage IB2, 1 patient stage IIA and 1 patient stage IIIB. Tumor histology revealed squamous cell carcinoma in 8 patients, adenocarcinoma in 1 and others in 3. Five patients with a gestation of < 20 weeks and stage IA1/IB1, and seven patients with a gestation of > 20 weeks and stage IB1/IB2/IIa/IIIb delayed treatment for 9 to 25 weeks and for 3 to 14 weeks to improve fetal maturity, respectively. Fetal outcome in the both groups was excellent. Two patients in latter group (stage IB1with delayed treatment for 3 weeks and stage IB2 with delayed treatment for 6 weeks) died after a relapse. The remaining ten patients are alive after a median follow-up of 40 months. Deliberate delay in treatment to improve fetal maturity would be a reasonable option for patients with invasive carcinoma of the uterine cervix during pregnancy.