Cervical Cancer in Pregnancy: A 10-Year Retrospective Analysis of Clinical Management and Future Perspectives.

Abstract

IntroductionThis study aims to evaluate diagnosis, treatment and clinical outcomes for patients with cervical cancer in pregnancy (CCIP) and their fetuses over a 10-year period, providing clinical evidence for the management of CCIP.MethodsClinical data of 28 patients diagnosed with CCIP at our center between January 1st, 2013 and June 30th, 2023 were retrospectively analyzed, focusing on gestational age at diagnosis, treatment, and maternal-fetal outcomes.ResultsA total of 28 patients with CCIP were identified, accounting for 0.42% (28/6678) of patients with cervical cancer during the study period. The majority of patients (86%, 24/28) had squamous cell carcinoma diagnosed by colposcopic biopsy, and 21 patients presented with recurrent vaginal bleeding. Cervical cancer was diagnosed during pregnancy in 19 cases and in the postpartum period in 9 cases. The mean tumor diameter was 5.4 (2-12) cm. Among 19 patients diagnosed during pregnancy, 13 patients chose pregnancy preservation, resulting in an average delay of treatment by 16.4 (0-33) weeks without observed disease progression. Fetuses were delivered via cesarean section at an average gestational age of 36.3 weeks; eight of these patients received neoadjuvant chemotherapy. At a median follow-up duration of 40.1 (12-103) months, 25 patients survived. Disease-free survival was observed in 20 patients, whereas two patients experienced local progression, and six developed distant metastases.ConclusionClinical outcomes for patients with CCIP appear comparable to those observed in non-pregnant patients in the general population. Pregnant patients presenting with abnormal vaginal bleeding should undergo prompt cervical cancer screening to enable early diagnosis and tailored management strategies. For patients with a strong desire to maintain their pregnancy, careful consideration should be given to postponing delivery until fetal maturity, thereby minimizing maternal and fetal complications and improving maternal and fetal outcomes.