Obstet Gynecol Sci.  2014 Nov;57(6):539-543. 10.5468/ogs.2014.57.6.539.

Neoadjuvant and postoperative chemotherapy with paclitaxel plus cisplatin for the treatment of FIGO stage IB cervical cancer in pregnancy

• Kong TW
• Lee EJ
• Lee Y
• Chang SJ
• Son JH
• Ryu HS

• KMID: 2314024
• DOI: http://doi.org/10.5468/ogs.2014.57.6.539

Abstract

Cervical cancer is one of the most common malignancy diagnosed during pregnancy. The experience of the use of neoadjuvant chemotherapy (NACT) with paclitaxel plus cisplatin during pregnancy is limited. Three pregnant women with International Federation of Gynecology and Obstetrics (FIGO) stage IB cervical cancer received NACT with paclitaxel plus cisplatin until fetal lung maturity, and then underwent cesarean delivery and radical hysterectomy. Two of our patients had intermediate pathologic risk factors, and received adjuvant chemotherapy with the same regimen used in NACT. All patients did not have any evidence of disease recurrence for follow-up of 3, 4, and 8 years, respectively. NACT with paclitaxel plus cisplatin followed by radical hysterectomy and adjuvant chemotherapy could be considered as one of feasible alternatives to primary radical surgery or concurrent chemoradiation therapy with the termination of pregnancy in pregnant women with FIGO stage IB cervical cancer who have two or more intermediate pathologic-risk factors.

Keyword

Cervical cancer; Neoadjuvant chemotherapy; Pregnancy

MeSH Terms

Chemotherapy, Adjuvant
Cisplatin*
Drug Therapy*
Female
Follow-Up Studies
Gynecology
Humans
Hysterectomy
Lung
Obstetrics
Paclitaxel*
Pregnancy*
Pregnant Women
Recurrence
Risk Factors
Uterine Cervical Neoplasms*
Cisplatin
Paclitaxel

Figure

• 

  Fig. 1 (A) Speculum examination shows an approximately 5-cm-sized mass on the cervix. (B) Magnetic resonance imaging (midsagittal T2-weighted) in a pregnant patient at 25 weeks' gestation before neoadjuvant chemotherapy shows a 5.4×5×5-cm cervical tumor.

• 

  Fig. 2 (A) Magnetic resonance imaging (midsagittal T2-weighted) in a pregnant patient at 33 weeks' gestation after neoadjuvant chemotherapy shows a 2.5×2×2-cm cervical tumor. (B) Photograph of the macroscopic surgical specimen after cesarean delivery and radical hysterectomy. (C) Hematoxylin and eosin staining (×200 objective lens) of squamous cell carcinoma, large cell, nonkeratinizing type.

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