Clinical management of epithelial ovarian cancer during pregnancy

TY - JOUR

T1 - Clinical management of epithelial ovarian cancer during pregnancy

AU - Grimm, Donata

AU - Woelber, Linn

AU - Trillsch, Fabian

AU - Keller-v. Amsberg, Gunhild

AU - Mahner, Sven

N1 - Copyright © 2014 Elsevier Ltd. All rights reserved.

PY - 2014/3/1

Y1 - 2014/3/1

N2 - UNLABELLED: Epithelial ovarian cancer (EOC) in pregnancy is a rare situation. Due to its low incidence with a consecutive lack of clinical trials many questions regarding indication of different treatment approaches are unanswered. This article discusses the current literature to elaborate recommendations for the management of EOC during pregnancy. A literature search of diagnostic approaches and treatment strategies for EOC complicated by pregnancy was performed. We reviewed the available information with emphasis on surgery as well as chemotherapeutical treatment options. EOC in pregnancy is often diagnosed at early stage and no data support that concurrent pregnancy influences the growth rate or propensity for spread of EOC. Radical cytoreduction of all visible tumour followed by subsequent systemic chemotherapy is the standard treatment of EOC in most non-pregnant women. In pregnant women, however, chemotherapy as well as radical surgery should be avoided in the first trimester because of teratogenesis and high abortion rates. Besides induced abortion followed by classic management of EOC, pregnancy preserving surgery, followed by chemotherapy in the second or third trimester, timely delivery as well as neo-adjuvant chemotherapy with subsequent completing surgery appear to be viable treatment options.CONCLUSIONS: Since there is only very limited information regarding the optimal therapeutic approach to EOC during pregnancy, each case needs to be addressed individually. Treatment in specialised centres should be intended especially in this rare and challenging situation.

AB - UNLABELLED: Epithelial ovarian cancer (EOC) in pregnancy is a rare situation. Due to its low incidence with a consecutive lack of clinical trials many questions regarding indication of different treatment approaches are unanswered. This article discusses the current literature to elaborate recommendations for the management of EOC during pregnancy. A literature search of diagnostic approaches and treatment strategies for EOC complicated by pregnancy was performed. We reviewed the available information with emphasis on surgery as well as chemotherapeutical treatment options. EOC in pregnancy is often diagnosed at early stage and no data support that concurrent pregnancy influences the growth rate or propensity for spread of EOC. Radical cytoreduction of all visible tumour followed by subsequent systemic chemotherapy is the standard treatment of EOC in most non-pregnant women. In pregnant women, however, chemotherapy as well as radical surgery should be avoided in the first trimester because of teratogenesis and high abortion rates. Besides induced abortion followed by classic management of EOC, pregnancy preserving surgery, followed by chemotherapy in the second or third trimester, timely delivery as well as neo-adjuvant chemotherapy with subsequent completing surgery appear to be viable treatment options.CONCLUSIONS: Since there is only very limited information regarding the optimal therapeutic approach to EOC during pregnancy, each case needs to be addressed individually. Treatment in specialised centres should be intended especially in this rare and challenging situation.

KW - Antineoplastic Agents

KW - Combined Modality Therapy

KW - Female

KW - Humans

KW - Neoplasms, Glandular and Epithelial

KW - Ovarian Neoplasms

KW - Ovariectomy

KW - Pregnancy

KW - Pregnancy Complications, Neoplastic

KW - Pregnancy Outcome

KW - Treatment Outcome

U2 - 10.1016/j.ejca.2013.12.020

DO - 10.1016/j.ejca.2013.12.020

M3 - SCORING: Journal article

C2 - 24462638

VL - 50

SP - 963

EP - 971

JO - EUR J CANCER

JF - EUR J CANCER

SN - 0959-8049

IS - 5

ER -