1
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Zhou JP, Wang Y, Lin YN, Sun XW, Ding YJ, Yan YR, Li N, Zhang L, Li QY. Clinical Features and Management of Lung Cancer During Pregnancy: A Narrative Review Based on Reported Cases. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2023; 4:544-550. [PMID: 38023372 PMCID: PMC10664570 DOI: 10.1089/whr.2023.0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 12/01/2023]
Abstract
This review aims to provide a summary of the clinical characteristics and outcomes of lung cancer during pregnancy. A comprehensive literature search yielded 93 cases of lung cancer during pregnancy from 1953 to 2022, with an average maternal age of ∼34 years old. The initial symptoms reported were often nonspecific, such as cough, dyspnea, and chest pain. Cancer-related treatments, including surgery, radiotherapy, chemotherapy, and tyrosine kinase inhibitors, have shown beneficial effects on maternal outcomes. A majority of the newborns were born without malformation or diseases, but extended follow-up remains necessary. Early diagnosis of lung cancer is imperative for reducing the risks of placental and fetal metastasis and enhancing overall survival.
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Affiliation(s)
- Jian Ping Zhou
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Wang
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Ni Lin
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xian Wen Sun
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Jie Ding
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ya Ru Yan
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ning Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liu Zhang
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Yun Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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2
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He H, Liu R, Zhou X, Zhang Y, Yu B, Xu Z, Huang H. B-Ultrasound Image Analysis of Intrauterine Pregnancy Residues after Mid-Term Pregnancy Based on Smart Medical Big Data. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:9937051. [PMID: 35222901 PMCID: PMC8866017 DOI: 10.1155/2022/9937051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 12/21/2021] [Indexed: 11/17/2022]
Abstract
Abdominal B-ultrasound images of intrauterine pregnancy tissue residues were analyzed to discuss their diagnostic value. With the rapid development of computer technology and medical imaging technology, doctors are also faced with more and more medical image diagnosis tasks, and computer-aided diagnosis systems are especially important in order to reduce the work pressure of doctors. In recent years, deep learning has made rapid development and achieved great breakthroughs in various fields. In medical-aided diagnostic systems, deep learning has greatly improved the diagnostic efficiency, but there are no mature research results for abdominal B-ultrasound image recognition of intrauterine pregnancy tissue residues. Therefore, the study of liver ultrasound image classification based on deep learning has important practical application value. In this paper, we propose to give a CNN model optimization method based on grid search. Compared with the conventional CNN model design, this method saves time and effort by eliminating the need to manually adjust parameters based on experience and has an accuracy of more than 92% in classifying abdominal B-ultrasound images of intrauterine pregnancy tissue residues. The diagnosis of intrauterine pregnancy tissue residues by abdominal B-ultrasound can effectively improve the diagnosis and provide important reference for patients to receive treatment, which has high diagnostic value.
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Affiliation(s)
- Huiliao He
- Ultrasound Imaging Department, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Ruixing Liu
- Ultrasound Imaging Department, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xiuping Zhou
- Ultrasound Imaging Department, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yinhong Zhang
- Ultrasound Imaging Department, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Beibei Yu
- Ultrasound Imaging Department, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Zhihua Xu
- Ultrasound Imaging Department, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Hu Huang
- Ultrasound Imaging Department, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
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3
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Leclair NK, Lambert WA, Wu Q, Wolansky L, Becker K, Li L, Leishangthem L, Bulsara KR. Genomic sequencing of a pregnancy associated symptomatic meningioma of the diaphragma sellae: a case report. Br J Neurosurg 2022:1-5. [PMID: 35001774 DOI: 10.1080/02688697.2021.2024503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/29/2021] [Accepted: 12/27/2021] [Indexed: 11/02/2022]
Abstract
Pregnancy-associated meningiomas have unique considerations and features regarding their pathophysiology, location, genetic profile, and neurosurgical management. These tumours have been reported to undergo rapid growth during gestation and regression post-partum, implicating a role for female sex hormones in tumour physiology. In addition, these tumours occur at a higher incidence in the skull base compared to sporadic meningiomas in the general population, often impinging neurovascular structures and requiring emergent resection. While the genomics of sporadic meningiomas have been described, there are no reports characterizing the genetic features of those associated with pregnancy. Here we describe a patient diagnosed with a diphragma sellae meningioma early in the third trimester after presenting with rapidly deteriorating vision. At 32 weeks gestation the baby was delivered by caesarean section and the tumour subsequently removed. Genomic profiling of the tumour sample revealed variants of unknown significant (VUS) in six genes, none of which were in canonical meningioma drivers. We describe our surgical approach and discuss the relevant pathology and genomics, as well as medical and surgical management considerations of meningiomas in pregnancy.
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Affiliation(s)
- Nathan K Leclair
- School of Medicine, University of Connecticut, Farmington, CT, USA
| | | | - Qian Wu
- Department of Pathology and Laboratory Medicine, UConn Health, Farmington, CT, USA
| | - Leo Wolansky
- Department of Radiology, UConn Health, Farmington, CT, USA
| | - Kevin Becker
- Department of Oncology, UConn Health, Farmington, CT, USA
| | - Lei Li
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | | | - Ketan R Bulsara
- Division of Neurosurgery, Department of Surgery, UConn Health, Farmington, CT, USA
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4
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Zhang M, Zhou J, Wang L. Breast cancer and pregnancy: Why special considerations prior to treatment are needed in multidisciplinary care. Biosci Trends 2021; 15:276-282. [PMID: 34556594 DOI: 10.5582/bst.2021.01187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Breast cancer diagnosed during pregnancy poses ethical and professional challenges. Clinical management of that condition should ensure the safety of both the mother and fetus. Clinical trials on breast cancer exclude pregnant women, so sufficient evidence with which to formulate guidelines for the management of these patients is lacking. Failing to undergo a breast examination during pregnancy, breast symptoms explained by physiological changes such as pregnancy, and unnecessary abortions after the diagnosis of breast cancer lead to worse outcomes for these patients. Multidisciplinary teams including breast surgeons, obstetricians, radiologists, pathologists, and anesthesiologists need to make an early diagnosis and comprehensively evaluate patients in different gestational weeks and with different stages of breast cancer in order to optimize outcomes.
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Affiliation(s)
- Mingdi Zhang
- Department of Breast Surgery, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Jing Zhou
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.,The Academy of Integrative Medicine of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
| | - Ling Wang
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.,The Academy of Integrative Medicine of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
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5
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Murrieta-Coxca JM, Aengenheister L, Schmidt A, Markert UR, Buerki-Thurnherr T, Morales-Prieto DM. Addressing microchimerism in pregnancy by ex vivo human placenta perfusion. Placenta 2021; 117:78-86. [PMID: 34773744 DOI: 10.1016/j.placenta.2021.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 10/07/2021] [Accepted: 10/10/2021] [Indexed: 12/20/2022]
Abstract
The physical connection of mother and offspring during pregnancy allows the bi-directional exchange of a small number of cells through the placenta. These cells, which can persist long-term in the recipient individual are genetically foreign to it and therefore fulfill the principle of microchimerism. Over the last years, pioneer research on microchimeric cells revealed their role in immune adaptation during pregnancy and priming of tolerogenic responses in the progeny. However, the mechanisms involved in cell transfer across the placenta barrier remain poorly investigated. In this review, we summarize the evidence of fetomaternal microchimerism, propose a mechanism for cell trafficking through the placenta and discuss the different models and techniques available for its analysis. Likewise, we aim to generate interest in the use of ex vivo placenta perfusion to investigate microchimerism in physiological and pathological settings.
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Affiliation(s)
| | - Leonie Aengenheister
- Laboratory for Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, Switzerland
| | - Astrid Schmidt
- Placenta Lab, Department of Obstetrics, Jena University Hospital, Jena, Germany
| | - Udo R Markert
- Placenta Lab, Department of Obstetrics, Jena University Hospital, Jena, Germany.
| | - Tina Buerki-Thurnherr
- Laboratory for Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, Switzerland
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6
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Fox CR, Burdeaux S, Downing KT. A 33-Year-Old Woman in the Third Trimester of Pregnancy Diagnosed with Advanced-Staged Squamous Cell Cervical Carcinoma by Magnetic Resonance Imaging and Biopsy. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e933639. [PMID: 34644286 PMCID: PMC8522525 DOI: 10.12659/ajcr.933639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Patient: Female, 33-year-old
Final Diagnosis: Cervix cancer • squamous cell carcinoma
Symptoms: Cervical mass • lymphadenopathy • vaginal bleeding
Medication: —
Clinical Procedure: Magnetic resonance imaging (MRI)
Specialty: Obstetrics and Gynecology
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Affiliation(s)
- Courtney R Fox
- Department of Obstetrics and Gynecology, Good Samaritan Hospital, West Islip, NY, USA
| | - Shayna Burdeaux
- Department of Obstetrics and Gynecology, Good Samaritan Hospital, West Islip, NY, USA
| | - Keith T Downing
- Department of Obstetrics and Gynecology, Good Samaritan Hospital, West Islip, NY, USA
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7
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Tafesse TB, Bule MH, Khan F, Abdollahi M, Amini M. Developing Novel Anticancer Drugs for Targeted Populations: An Update. Curr Pharm Des 2021; 27:250-262. [PMID: 33234093 DOI: 10.2174/1381612826666201124111748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 08/16/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Due to higher failure rates, lengthy time and high cost of the traditional de novo drug discovery and development process, the rate of opportunity to get new, safe and efficacious drugs for the targeted population, including pediatric patients with cancer, becomes sluggish. OBJECTIVES This paper discusses the development of novel anticancer drugs focusing on the identification and selection of targeted anticancer drug development for the targeted population. METHODS Information presented in this review was obtained from different databases, including PUBMED, SCOPUS, Web of Science, and EMBASE. Various keywords were used as search terms. RESULTS The pharmaceutical companies currently are executing drug repurposing as an alternative means to accelerate the drug development process that reduces the risk of failure, time and cost, which take 3-12 years with almost 25% overall probability of success as compared to de novo drug discovery and development process (10- 17 years) which has less than 10% probability of success. An alternative strategy to the traditional de novo drug discovery and development process, called drug repurposing, is also presented. CONCLUSION Therefore, to continue with the progress of developing novel anticancer drugs for the targeted population, identification and selection of target to specific disease type is important. Considering the aspects of the age of the patient and the disease stages such as each cancer types are different when we study the disease at a molecular level. Drug repurposing technique becomes an influential alternative strategy to discover and develop novel anticancer drug candidates.
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Affiliation(s)
- Tadesse B Tafesse
- Department of Medicinal Chemistry, School of Pharmacy, Drug Design and Development Research Center and The Institute of Pharmaceutical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammed H Bule
- Department of Medicinal Chemistry, School of Pharmacy, Drug Design and Development Research Center and The Institute of Pharmaceutical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Fazlullah Khan
- Department of Allied Health Sciences, Bashir Institute of Health Sciences, Bhara Kahu Islamabad, Iran
| | - Mohammad Abdollahi
- Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), and Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mohsen Amini
- Department of Medicinal Chemistry, School of Pharmacy, Drug Design and Development Research Center and The Institute of Pharmaceutical Sciences, Tehran University of Medical Sciences, Tehran, Iran
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8
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Allouch S, Gupta I, Malik S, Al Farsi HF, Vranic S, Al Moustafa AE. Breast Cancer During Pregnancy: A Marked Propensity to Triple-Negative Phenotype. Front Oncol 2021; 10:580345. [PMID: 33425733 PMCID: PMC7786283 DOI: 10.3389/fonc.2020.580345] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 11/20/2020] [Indexed: 12/19/2022] Open
Abstract
Breast and cervical cancers comprise 50% of all cancers during pregnancy. In particular, gestational breast cancer is considered one of the most aggressive types of cancers, which is a rare but fatal disease. However, the incidence of this type of cancer is increasing over the years and its prevalence is expected to rise further as more women delay childbearing. Breast cancer occurring after pregnancy is generally triple negative with specific characterizations of a poorer prognosis and outcome. On the other hand, it has been pointed out that this cancer is associated with a specific group of genes which can be used as precise targets to manage this deadly disease. Indeed, combination therapies consisting of gene-based agents with other cancer therapeutics is presently under consideration. We herein review recent progress in understanding the development of breast cancer during pregnancy and their unique subtype of triple negative which is the hallmark of this type of breast cancer.
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Affiliation(s)
- Soumaya Allouch
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Ishita Gupta
- College of Medicine, QU Health, Qatar University, Doha, Qatar.,Biomedical Research Center, Qatar University, Doha, Qatar
| | - Shaza Malik
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | | | - Semir Vranic
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Ala-Eddin Al Moustafa
- College of Medicine, QU Health, Qatar University, Doha, Qatar.,Biomedical Research Center, Qatar University, Doha, Qatar
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9
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Jeremic K, Stefanovic A, Dotlic J, Kadija S, Kontic O, Gojnic M, Jeremic J, Kesic V. Cancer during pregnancy - clinical characteristics, treatment outcomes and prognosis for mothers and infants. J Perinat Med 2018; 46:35-45. [PMID: 28222037 DOI: 10.1515/jpm-2016-0212] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 01/12/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To assess which obstetrical characteristics and treatment improved outcomes and prognosis of pregnant women with malignancy. METHODS A prospective study, undertaken between 2005 and 2014, involving 35 pregnant women who were diagnosed with malignant tumors during pregnancy. Patients were followed-up for 1 year after delivery. The pregnancy course and outcome and parameters that could influence the condition of mother and fetus were evaluated. RESULTS Most malignancies were hematological, diagnosed in the second trimester and treated with combined therapy (surgery/adjuvant) after pregnancy. Most fetuses were in good state throughout pregnancy, but were delivered by caesarean section (CS) before term. Adjuvant therapy during pregnancy mostly caused transitory deterioration of fetal conditions. The majority of both mothers and infants were in a good state 12 months postpartum, although numerous mothers were still ill and on therapy. Surviving pregnancy and preventing tumors progression during pregnancy were the best predictors of mothers' future condition (P=0.022). High birthweight and term delivery were the most important factors for good outcome of the infants (P=0.001). CONCLUSIONS If the tumor is not progressing, pregnancy should be continued as long as possible to obtain adequate birthweight of the infant. Second trimester surgery is safe, while other therapies should preferably be applied after delivery.
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Affiliation(s)
- Katarina Jeremic
- Clinic of Obstetrics and Gynecology, Clinical Centre of Serbia, Dr Koste Todorovica 26, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Dr Subotica 8, Belgrade, Serbia
| | - Aleksandar Stefanovic
- Clinic of Obstetrics and Gynecology, Clinical Centre of Serbia, Dr Koste Todorovica 26, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Dr Subotica 8, Belgrade, Serbia
| | - Jelena Dotlic
- Clinic of Obstetrics and Gynecology, Clinical Centre of Serbia, Dr Koste Todorovica 26, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Dr Subotica 8, Belgrade, Serbia
| | - Sasa Kadija
- Clinic of Obstetrics and Gynecology, Clinical Centre of Serbia, Dr Koste Todorovica 26, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Dr Subotica 8, Belgrade, Serbia
| | - Olivera Kontic
- Clinic of Obstetrics and Gynecology, Clinical Centre of Serbia, Dr Koste Todorovica 26, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Dr Subotica 8, Belgrade, Serbia
| | - Miroslava Gojnic
- Clinic of Obstetrics and Gynecology, Clinical Centre of Serbia, Dr Koste Todorovica 26, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Dr Subotica 8, Belgrade, Serbia
| | - Jelena Jeremic
- Clinic for Plastic and Reconstructive Surgery, Clinical Center of Serbia, Zvecanska 9, Belgrade, Serbia
| | - Vesna Kesic
- Clinic of Obstetrics and Gynecology, Clinical Centre of Serbia, Dr Koste Todorovica 26, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Dr Subotica 8, Belgrade, Serbia
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10
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Current approaches in the clinical management of pregnancy-associated breast cancer-pros and cons. EPMA J 2018; 9:257-270. [PMID: 30174762 DOI: 10.1007/s13167-018-0139-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 06/04/2018] [Indexed: 02/07/2023]
Abstract
Malignancies are one of the leading causes of mortality in women during their reproductive life. Treatment of gynecological malignant tumors during pregnancy is possible but not simple, since it creates a conflict between care of the mother and the fetus. BC is the most prevalent malignancy diagnosed in pregnancy, ranking up to 21% of all pregnancy-related malignancies. Due to its stets increasing prevalence, aggressive cancer subtype, and severe ethical and psychological aspects linked to the disease, experts raise an alarm for an acute necessity to improve the overall management of the PABC-the issue which has strongly motivated our current paper. Comprehensive research data and clinical experience accumulated in recent years have advanced our understanding of the disease complexity. PABC treatment must be individualized with an emphasis on optimal care of the mother, while observing standard treatment protocols with regard to safety of the fetus. Treatment protocols should be elaborated based on the individualized patient profile, bearing in mind the acute danger to the mother, maximizing the therapy efficacy and minimizing harmful effects to the fetus. Complex consulting on treatment options, their impacts on pregnancy and potential teratogenic effects requires tight "doctor-patient" collaboration. Complications that may arise due to the treatment of breast cancer in pregnancy require a multiprofessional expertise including oncologists, neonatologists, perinatologists, obstetricians, teratologists, and toxicologists, and an extensive psychological support throughout the pregnancy and after giving birth. Thereby, specifically psychological aspects of PABC diagnosis and follow-up are frequently neglected, being not yet adequately explored in the entire disease management approach. Herewith, we update the status quo regarding the currently available diagnostic modalities, complex treatment algorithms, and novel clinical approaches which altogether argue for an urgent necessity of a paradigm shift moving away from reactive to predictive, preventive, and personalized medical approach in the overall management of PABC meeting the needs of young populations, persons at high risk, affected patients, and families as the society at large.
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11
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Malignancy during pregnancy in Japan: an exceptional opportunity for early diagnosis. BMC Pregnancy Childbirth 2018; 18:50. [PMID: 29422016 PMCID: PMC5806462 DOI: 10.1186/s12884-018-1678-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 01/30/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Malignancy during pregnancy has become a significant cause of maternal death in developed countries, likely due to both an older pregnant population, and increases of cervical cancer in younger women. Our aim is to investigate the clinical aspects of malignancy during pregnancy in Japan and to use this information to identify opportunities for earlier detection and treatment. METHODS We provided a questionnaire to 1508 secondary or tertiary care hospitals in Japan. We reviewed the clinical characteristics of cases with malignancy during pregnancy for the period of January to December, 2008. From the 760 institutions which responded, we obtained clinical information for 227 unique cases. The questionnaire provided clinical information, including disease site, pregnancy outcome and how the disease was detected. RESULTS The most common type of malignancy was cervical cancer (n = 162, 71.4%) followed by ovarian (n = 16, 7.0%) and breast cancer (n = 15, 6.6%). Leukemia (n = 7, 3.1%), colon cancer (n = 5, 2.2%), gastric cancer (n = 5, 2.2%), malignant lymphoma (n = 4, 1.8%), thyroid cancer (n = 3, 1.3%), brain cancer (n = 3, 1.3%), endometrial cancer (n = 2, 0.9%), and head and neck cancer (n = 2, 0.9%) accounted for the remaining cases. Overall, gynecological malignancies accounted for 79.3% (95% confidence interval 74.0-84.6) of pregnancy associated malignancies diagnosed in the present study. The majority of cervical cancers, 149 (92.0%) of 162, were diagnosed by a Pap (Papanicolaou) smear during early gestation. Ten (62.5%) of the ovarian cancer cases were diagnosed by ultrasonography during a prenatal checkup or at the time of initial pregnancy diagnosis. Out of 14 breast cancers, only one (7.1%) was diagnosed by screening breast exam. CONCLUSIONS From this study, we reaffirm the clear and significant benefits of prenatal checkups starting at an early gestational age for the detection of gynecological cancers during pregnancy. Conversely, breast cancer detection during pregnancy was poor, suggesting new strategies for early identification of this disease are required.
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12
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Singhal SR, Chaudhary S, Agarwal K, Gupta A. Successful Pregnancy Outcome in Recurrent Ovarian Cancer in a 26 Year Old: A Case Report. J Family Reprod Health 2017; 11:225-227. [PMID: 30288170 PMCID: PMC6168754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objective: To report a case of Successful Pregnancy Outcome in Recurrent Ovarian Cancer in a 26 year Old. Case Report: A 26 years old primigravida presented in antenatal clinic at 23 weeks of pregnancy with recurrence of ovarian cancer of mucinous type. Following refusal of surgical management, two courses of single dose carboplatin was administered. However, before third cycle of chemotherapy could be administered ,there was deranged liver functions tests, following which elective Cesarean section with staging laparotomy was planned at 34 weeks for breech presentation with oligohydramnios. A live healthy baby girl 2.3kg was delivered. Total abdominal hysterectomy with right salpingo-oopherectomy, infracolic omentectomy, appendectomy was done. The final diagnosis was recurrent mucinous ovarian adenocarcinoma. Postoperatively, she was given six cycles of chemotherapy (carboplatin and paclitaxel). Conclusion: Chemotherapy and surgery, both are safe beyond first trimester and multidisciplinary treatment must be planned after taking into account the wishes of couple.
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13
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Mangel L, Bíró K, Battyáni I, Göcze P, Tornóczky T, Kálmán E. A case study on the potential angiogenic effect of human chorionic gonadotropin hormone in rapid progression and spontaneous regression of metastatic renal cell carcinoma during pregnancy and after surgical abortion. BMC Cancer 2015; 15:1013. [PMID: 26704433 PMCID: PMC4691015 DOI: 10.1186/s12885-015-2031-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 12/17/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Treatment possibilities of metastatic renal cell carcinoma (mRCC) have recently changed dramatically prolonging the overall survival of the patients. This kind of development brings new challenges for the care of mRCC. CASE PRESENTATION A 22 year-old female patient with translocation type mRCC, who previously had been treated for nearly 5 years, became pregnant during the treatment break period. Follow-up examinations revealed a dramatic clinical and radiological progression of mRCC in a few weeks therefore the pregnancy was terminated. A few days after surgical abortion, CT examination showed a significant spontaneous regression of the pulmonary metastases, and the volume of the largest manifestation decreased from ca. 30 to 3.5 cm(3) in a week. To understand the possible mechanism of this spectacular regression, estrogen, progesterone and luteinizing hormone receptors (ER, PGR and LHR, respectively) immuno-histochemistry assays were performed on the original surgery samples. Immuno-histochemistry showed negative ER, PGR and positive LHR status suggesting the possible angiogenic effect of human chorionic gonadotropin hormone (hCG) in the background. CONCLUSION We hypothesize that pregnancy may play a causal role in the progression of mRCC via the excess amount of hCG, however, more data are necessary to validate the present notions and the predictive role of LHR overexpression.
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Affiliation(s)
- László Mangel
- Institute of Oncotherapy, University of Pécs, H-7624, Édesanyák útja 17, Pécs, Hungary.
| | - Krisztina Bíró
- Department of Chemotherapy, National Institute of Oncology, Budapest, Hungary.
| | | | - Péter Göcze
- Clinic of Obstetrics and Gynecology, University of Pécs, Pécs, Hungary.
| | | | - Endre Kálmán
- Institute of Pathology, University of Pécs, Pécs, Hungary.
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Basta P, Bak A, Roszkowski K. Cancer treatment in pregnant women. Contemp Oncol (Pozn) 2014; 19:354-60. [PMID: 26793018 PMCID: PMC4709394 DOI: 10.5114/wo.2014.46236] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 08/08/2014] [Indexed: 12/17/2022] Open
Abstract
In general, strategies for the treatment of cancer in pregnancy should not differ significantly from the treatment regimens in non-pregnant women. However, this is difficult due to either the effects of anticancer drugs on the developing foetus or the possibility of long-term complications after the exposure to drugs and radiation. The decision about the introduction and continuation of treatment in the event of pregnancy should be preceded by a detailed analysis of the potential benefits and risks. There are no data to suggest that pregnancy termination alters the biological behaviour of the tumour or patient prognosis in the presence of appropriate antineoplastic therapy. All patients should be given appropriate advice and informed that there are insufficient scientific data to determine any generally accepted consensus. It is very important to always respect the will of the patient, and the moral judgment of the physician should have no impact on the decisions taken by the woman. If the woman decides to undergo active treatment and maintain her pregnancy, it is necessary to carry out consultations with experts in the field appropriate to the type of cancer. This paper presents a basic review of the literature on the targeted therapies currently used in selected cancers diagnosed during pregnancy: breast cancer, cervical cancer, Hodgkin's disease, melanoma, thyroid cancer, ovarian cancer, and colorectal cancer.
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Affiliation(s)
- Pawel Basta
- I Department of Surgery, Jagiellonian University, Medical College, Krakow, Poland
- Department of Gynaecology and Oncology, Lukaszczyk Oncology Centre, Bydgoszcz, Poland
| | - Anna Bak
- Department of Radiotherapy, Lukaszczyk Oncology Centre, Bydgoszcz, Poland
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Administration of Chemo-radiation during pregnancy: An evidence-based treatment strategy. Br J Oral Maxillofac Surg 2014. [DOI: 10.1016/j.bjoms.2014.07.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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