Outcomes of gynecological and breast cancer among female patients with cirrhosis: Scoping review of the literature

The incidence of gynecological and breast cancers is on the rise in addition to a rise in the incidence of cirrhosis among women. Women with cirrhosis are generally excluded from clinical trials therefore little is known about the oncologic and/or liver-related outcomes in this population. The aim of this study was to review the current literature regarding treatment and survival outcomes in females with gynecological or breast cancer with underlying cirrhosis. An electronic search was conducted for studies reporting outcomes among females with cirrhosis and gynecological and breast cancer. References were reviewed for relevant publications. Studies were reviewed and data were extracted from publications. Three thousand one hundred ninety one articles were identified, and five studies were reviewed in full. Thirty unique patients were identified. Ten patients with breast cancer were identified, 9/10 patients did not have cancer recurrence in the follow-up period, and 1/10 did not have follow up. 1/10 patient's received chemotherapy and developed degree II abnormal liver function and bone marrow suppression. 2/9 patients experienced postoperative complications, one had worsening thrombocytopenia and one developed mild encephalopathy. Nienteen patients with ovarian cancer all received surgery and chemotherapy. 10/19 had postoperative complications and 1/19 died in follow-up period. One patient had a neuroendocrine uterine cancer stage IV who died after one cycle of chemotherapy. There is limited data on the outcomes and management of patients with both cirrhosis and gynecological or breast cancers. Therefore, further work is necessary to address these gaps in clinical practice to improve patient care.