Adjuvant Chemotherapy for Malignant Ovarian Germ Cell Tumors in Pregnancy
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Published:
Oct 1, 2019
Keywords:
malignant ovarian germ cell tumor ovarian cancer pregnancy management chemotherapy
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Abstract
Malignant ovarian germ cell tumors (MOGCTs) are uncommon in pregnancy, and therefore few gynecologic oncologists obtain expertise in this area. Management of MOGCTs in pregnancy is complicated and complex, requiring a multidisciplinary team in a specialized center. Fertility-sparing surgery is the first choice treatment of MOGCTs, while adjuvant chemotherapy is reserved for high risk cases. The indications for adjuvant chemotherapy after surgery are similar to those for non-pregnant women. Due to the low incidence and insufficient published data, the decision concerning adjuvant chemotherapy is based on case reports or small retrospective cohort studies. Following is a brief review of current knowledge concerning the MOGCTs in pregnancy and its management, especially, adjuvant chemotherapy.
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(1)
Hanprasertpong, J.; Dhanaworavibul, K.; Sueblinvong, T. Adjuvant Chemotherapy for Malignant Ovarian Germ Cell Tumors in Pregnancy. Thai J Obstet Gynaecol 2019, 27, 176-179.
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References
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26. Benjapibal M, Chaopotong P, Leelaphatanadit C, Jaishuen A. Ruptured ovarian endodermal sinus tumor diagnosed during pregnancy: case report and review of the literature. J Obstet Gynaecol Res 2010;36:1137-41.
2. Peccatori FA, Azim HA Jr, Orecchia R, Hoekstra HJ, Pavlidis N, Kesic V, et al. Cancer, pregnancy and fertility: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013;24 Suppl 6:vi160-70.
3. Kodama M, Grubbs BH, Blake EA, Cahoon SS, Murakami R, Kimura T, et al. Feto-maternal outcomes of pregnancy complicated by ovarian malignant germ cell tumor: a systematic review of literature. Eur J Obstet Gynecol Reprod Biol 2014;181:145-56.
4. Amant F, Van Calsteren K, Halaska MJ, Beijnen J, Lagae L, Hanssens M, et al. Gynecologic cancers in pregnancy: guidelines of an international consensus meeting. Int J Gynecol Cancer 2009;19 Suppl 1:S1-12.
5. Mangili G, Sigismondi C, Lorusso D, Cormio G, Candiani M, Scarfone G, et al. The role of staging and adjuvant chemotherapy in stage I malignant ovarian germ cell tumors (MOGTs): the MITO-9 study. Ann Oncol 2017;28:333-8.
6. Morice P, Uzan C, Gouy S, Verschraegen C, Haie-Meder C. Gynaecological cancers in pregnancy. Lancet 2012;379:558-69.
7. Han SN, Van Calsteren K, Amant F. Use of chemotherapy during pregnancy in the treatment of ovarian malignancies. Eur J Obstet Gynecol Reprod Biol 2011;156:237.
8. Ngu SF, Ngan HY. Chemotherapy in pregnancy. Best Pract Res Clin Obstet Gynaecol 2016;33:86-101.
9. Amant F, Berveiller P, Boere I, Cardonick E, Fruscio R, Fumagalli M, et al. Gynecologic cancers in pregnancy: guidelines based on a third international consensus meeting. Ann Oncol 2019 Aug 21. pii: mdz228. doi: 10.1093/annonc/mdz228. [Epub ahead of print]
10. Hepner A, Negrini D, Hase EA, Exman P, Testa L, Trinconi AF, et al. Cancer during pregnancy: The oncologist overview. World J Oncol 2019;10:28-34.
11. Vandenbroucke T, Verheecke M, Fumagalli M, Lok C, Amant F. Effects of cancer treatment during pregnancy on fetal and child development. Lancet Child Adolesc Health 2017;1:302-10.
12. Weisz B, Meirow D, Schiff E, Lishner M. Impact and treatment of cancer during pregnancy. Expert Rev Anticancer Ther 2004;4:889-902.
13. Zagouri F, Dimitrakakis C, Marinopoulos S, Tsigginou A, Dimopoulos MA. Cancer in pregnancy: disentangling treatment modalities. ESMO Open 2016;1:e000016.
14. Machado F, Vegas C, Leon J, Perez A, Sanchez R, Parrilla JJ, et al. Ovarian cancer during pregnancy: analysis of 15 cases. Gynecol Oncol 2007;105:446-50.
15. Hubalek M, Smekal-Schindelwig C, Zeimet AG, Sergi C, Brezinka C, Mueller-Holzner E, et al. Chemotherapeutic treatment of a pregnant patient with ovarian dysgerminoma. Arch Gynecol Obstet 2007;276:179-83.
16. Elit L, Bocking A, Kenyon C, Natale R. An endodermal sinus tumor diagnosed in pregnancy: case report and review of the literature. Gynecol Oncol 1999;72:123-7.
17. Raffles A, Williams J, Costeloe K, Clark P. Transplacental effects of maternal cancer chemotherapy. Case report. Br J Obstet Gynaecol 1989;96:1099-100.
18. McNeish IA, Kanfer EJ, Haynes R, Giles C, Harland SJ, Driver D, et al. Paclitaxel-containing high-dose chemotherapy for relapsed or refractory testicular germ cell tumours. Br J Cancer 2004;90:1169-75.
19. Taylor MH, Depetrillo AD, Turner AR. Vinblastine, bleomycin, and cisplatin in malignant germ cell tumors of the ovary. Cancer 1985;56:1341-9.
20. Cuvier C, Espie M, Extra JM, Marty M. Vinorelbine in pregnancy. Eur J Cancer 1997;33:168-9.
21. Motegi M, Takakura S, Takano H, Tanaka T, Ochiai K. Adjuvant chemotherapy in a pregnant woman with endodermal sinus tumor of the ovary. Obstet Gynecol 2007;109(2 Pt2):537-40.
22. Amant F, Halaska MJ, Fumagalli M, Dahl Steffensen K, Lok C, Van Calsteren K, et al. Gynecologic cancers in pregnancy: guidelines of a second international consensus meeting. Int J Gynecol Cancer 2014;24:394-403.
23. Han JY, Nava-Ocampo AA, Kim TJ, Shim JU, Park CT. Pregnancy outcome after prenatal exposure to bleomycin, etoposide and cisplatin for malignant ovarian germ cell tumors: report of 2 cases. Reprod Toxicol 2005;19:557-61.
24. Cardonick E, Usmani A, Ghaffar S. Perinatal outcomes of a pregnancy complicated by cancer, including neonatal follow-up after in utero exposure to chemotherapy: results of an international registry. Am J Clin Oncol 2010;33:221-8.
25. Ghaemmaghami F, Abbasi F, Abadi AG. A favorable maternal and neonatal outcome following chemotherapy with etoposide, bleomycin, and cisplatin for management of grade 3 immature teratoma of the ovary. J Gynecol Oncol 2009;20:257-9.
26. Benjapibal M, Chaopotong P, Leelaphatanadit C, Jaishuen A. Ruptured ovarian endodermal sinus tumor diagnosed during pregnancy: case report and review of the literature. J Obstet Gynaecol Res 2010;36:1137-41.