P Kocián1, J de Haan2,3, E H Cardonick4, C Uzan5,6, C A R Lok7, R Fruscio8, M J Halaska9, F Amant3,7,10,11. 1. a Department of Surgery, 2nd Medical Faculty , Charles University and Motol University Hospital , Prague , Czech Republic. 2. b Department of Obstetrics and Gynaecology , VU University Medical Centre , Amsterdam , Netherlands. 3. c Department of Oncology, KU Leuven , Leuven , Belgium. 4. d Department of Obstetrics and Gynaecology, Division Maternal Fetal Medicine , Cooper Medical School at Rowan University , Camden , United States of America. 5. e Department of Gynaecological Surgery , Institute Gustave Roussy , Villejuif , France. 6. f Department of Gynaecology and Breast Surgery , Pitié Salpêtrière Hospital, Institut Universitaire de Cancérologie, Sorbonne University , Paris , France. 7. g Center for Gynaecologic Oncology Amsterdam , Antoni van Leeuwenhoek-Netherlands Cancer Institute , Amsterdam , Netherlands. 8. h Division of Obstetrics and Gynaecology , San Gerardo Hospital, University of Milan-Bicocca , Monza , Italy. 9. i Department of Obstetrics and Gynaecology, 3rd Medical Faculty , Charles University and Faculty Hospital Kralovske Vinohrady , Prague , Czech Republic. 10. j Division of Gynaecologic Oncology , University Hospitals Leuven , Leuven , Belgium. 11. k Centre for Gynaecologic Oncology Amsterdam , Academic Medical Centre , Amsterdam , Netherlands.
Abstract
BACKGROUND: Colorectal cancer in pregnancy is rare, with an incidence of 0.8 per 100,000 pregnancies. Advanced disease (stage III or IV) is diagnosed more frequently in pregnant patients. We aimed to review all cases of colorectal cancer in pregnancy from the International Network on Cancer, Infertility and Pregnancy database in order to learn more about this rare disease and improve its management. METHODS: Data on the demographic features, symptoms, histopathology, diagnostic and therapeutic interventions and outcomes (obstetric, neonatal and maternal) were analysed. RESULTS: Twenty-seven colon and 14 rectal cancer cases were identified. Advanced disease was present in 30 patients (73.2%). During pregnancy, 21 patients (51.2%) received surgery and 12 patients (29.3%) received chemotherapy. Thirty-three patients (80.5%) delivered live babies: 21 by caesarean section and 12 vaginally. Prematurity rate was high (78.8%). Eight babies were small for gestational age (27.6%). Three patients (10.7%) developed recurrence of disease. Overall 2-year survival was 64.4%. CONCLUSION: Despite a more frequent presentation with advanced disease, colorectal cancer has a similar prognosis in pregnancy when compared with the general population. Diagnostic interventions and treatment should not be delayed due to the pregnancy but a balance between maternal and foetal wellbeing must always be kept in mind.
BACKGROUND:Colorectal cancer in pregnancy is rare, with an incidence of 0.8 per 100,000 pregnancies. Advanced disease (stage III or IV) is diagnosed more frequently in pregnant patients. We aimed to review all cases of colorectal cancer in pregnancy from the International Network on Cancer, Infertility and Pregnancy database in order to learn more about this rare disease and improve its management. METHODS: Data on the demographic features, symptoms, histopathology, diagnostic and therapeutic interventions and outcomes (obstetric, neonatal and maternal) were analysed. RESULTS: Twenty-seven colon and 14 rectal cancer cases were identified. Advanced disease was present in 30 patients (73.2%). During pregnancy, 21 patients (51.2%) received surgery and 12 patients (29.3%) received chemotherapy. Thirty-three patients (80.5%) delivered live babies: 21 by caesarean section and 12 vaginally. Prematurity rate was high (78.8%). Eight babies were small for gestational age (27.6%). Three patients (10.7%) developed recurrence of disease. Overall 2-year survival was 64.4%. CONCLUSION: Despite a more frequent presentation with advanced disease, colorectal cancer has a similar prognosis in pregnancy when compared with the general population. Diagnostic interventions and treatment should not be delayed due to the pregnancy but a balance between maternal and foetal wellbeing must always be kept in mind.
Authors: Jane E Rogers; Terri L Woodard; Graciela Mn Gonzalez; Arvind Dasari; Benny Johnson; Van K Morris; Bryan Kee; Eduardo Vilar; Y Nancy You; George J Chang; Brian Bednarski; John M Skibber; Miguel A Rodriguez-Bigas; Cathy Eng Journal: Obstet Med Date: 2021-09-07