Cervical cancer in pregnant women: treat, wait or interrupt? Assessment of current clinical guidelines, innovations and controversies

Abstract

Cervical cancer during pregnancy is relatively uncommon. However, the incidence is expected to increase as more women delay childbearing. When preservation of the pregnancy is desired, optimal treatment is a major challenge to all. Whereas delay of treatment is an option for pre-invasive disease, and also small invasive carcinomas without lymph node involvement, management of tumours >2 cm remains experimental. Type of treatment needs to be individualized and depends mainly on gestational age, disease stage, and histology. Extensive counselling regarding the maternal and foetal risks is required. In this current review, we aim to summarize available data and treatment guidelines concerning cervical cancer in pregnancy. Controversies and research priorities are also identified.

Keywords: cervical cancer; chemotherapy; neonatal; pregnancy.

Conflict of interest statement

Conflict of interest statement: FA is senior clinical investigator for the Research Foundation-Flanders (F.W.O.).

Figures

Figure 1.

MRI of the cervix in the midsagittal plane. Upper arrow: uterus containing the foetus (16 weeks gestation). Lower arrow: tumour of the cervix, 6 cm diameter. Biopsy confirms a squamous cell carcinoma of the cervix. FIGO stage IB2.