妊娠期癌症宫颈癌：管理和孕产妇及围产期结果
Cervical cancer during pregnancy: Management and maternal and perinatal outcomes.
摘要(中文译文)
妊娠期宫颈癌的发病率为每10万次妊娠1.5至12例。由于其罕见性，该人群的管理基于病例系列和专家意见。本研究旨在分享我们在妊娠期宫颈癌患者诊疗方面的经验，重点关注治疗方式、产科及围产期结局以及孕产妇生存情况。本前瞻性队列研究纳入了2013年1月至2023年12月期间入住我院的妊娠期宫颈癌患者。我们分析了患者年龄、临床分期、妊娠期及产后的肿瘤治疗、生存率以及产科和围产期结局。共纳入30例患者，平均年龄31.6岁（20-43岁）。73.3%的患者为鳞状细胞癌，66.7%的患者为局部晚期宫颈癌。妊娠期间，53.8%的患者接受了新辅助化疗，15.38%（4/26）接受了宫颈锥切术。分娩时平均孕龄为35.8周，61.5%的分娩为早产（孕龄<37周）。平均出生体重为2575.88 g。妊娠结束后，30例患者中22例（73.33%）接受了以铂类为基础的化疗和放疗，2例（6.66%）仅接受化疗。关于总生存期，平均随访时间为35.8个月（5.99-99.24个月）。总生存率在12个月时为94.4%，18个月时为82.6%，24个月时为62%。在本研究中，大多数妊娠女性被诊断为局部晚期宫颈癌，凸显了即使在妊娠期间宫颈癌筛查的重要性。新辅助化疗使妊娠得以延长并降低了极度早产的风险。然而，仍需更多研究才能得出明确结论。产前保健必须在三级中心由多学科和多专业团队提供，以优化母儿结局并提高孕产妇生存率。
Abstract
The incidence of cervical cancer during pregnancy ranges from 1.5 to 12 cases per 100,000 pregnancies. Due to its rarity, the management of this population is based on case series and expert opinions. This study aimed to share our experience in the care of pregnant women diagnosed with cervical cancer, focusing on treatment approaches, obstetric and perinatal outcomes, and maternal survival. This prospective cohort study included pregnant women with cervical cancer admitted to our institution between January 2013 and December 2023. We analyzed patient age, clinical stage, oncologic treatment during pregnancy and postpartum, survival rates, and obstetric and perinatal outcomes. A total of 30 patients were included, with an average age of 31.6 years (20-43 years). Squamous cell carcinoma was observed in 73.3 % of the patients, and 66.7 % of the patients presented locally advanced cancer. During pregnancy, 53.8 % of the patients received neoadjuvant chemotherapy and 15.38 % (4/26) underwent conization. The average gestational age (GA) at delivery was 35.8 weeks, with 61.5 % of deliveries occurring preterm (GA < 37 weeks). The average birth weight was 2575.88 g. Following pregnancy, of the 30 patients, 22 (73.33 %) received platinum-based chemotherapy and radiotherapy, while two (6.66 %) received only chemotherapy. Regarding overall survival, the average follow-up period was 35.8 months (5.99-99.24 months). The overall survival rates were 94.4 % at 12 months, 82.6 % at 18 months, and 62 % at 24 months. In this study, most of the pregnant women were diagnosed with locally advanced cervical cancer, highlighting the importance of cervical cancer screening even during pregnancy. Neoadjuvant chemotherapy allowed the pregnancy to be prolonged and reduced the risk of extreme prematurity. However, more studies are necessary to reach definitive conclusions. Prenatal care must be provided in tertiary centers by a multidisciplinary and multiprofessional team to optimize maternal and perinatal outcomes and increase maternal survival.
如何引用
AMA
Eliane Azeka Hase, Henrique Barata Ferreira, Stela Verzinhasse Peres, José Carlos Sadalla, Maria Del Pilar Estevez-Diz, Edmund Chada Baracat, et al. Cervical cancer during pregnancy: Management and maternal and perinatal outcomes.. Cancer treatment and research communications. 2026; doi:10.1016/j.ctarc.2026.101185.
APA
Eliane Azeka Hase, Henrique Barata Ferreira, Stela Verzinhasse Peres, José Carlos Sadalla, Maria Del Pilar Estevez-Diz, Edmund Chada Baracat, et al (2026). Cervical cancer during pregnancy: Management and maternal and perinatal outcomes.. Cancer treatment and research communications. https://doi.org/10.1016/j.ctarc.2026.101185
GB/T 7714
Eliane Azeka Hase, Henrique Barata Ferreira, Stela Verzinhasse Peres, José Carlos Sadalla, Maria Del Pilar Estevez-Diz, Edmund Chada Baracat, et al. Cervical cancer during pregnancy: Management and maternal and perinatal outcomes.[J]. Cancer treatment and research communications, 2026 doi:10.1016/j.ctarc.2026.101185.
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