Journal of Clinical Oncology, 2005 ASCO Annual Meeting Proceedings.
Vol 23, No 16S (June 1 Supplement), 2005: 9077
© 2005 American Society of Clinical Oncology

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Abstract

Bone and soft tissue sarcomas during pregnancy

King Faisal Specialist Hosp & Research Ctr, Riyadh, Saudi Arabia

9077

Background: Cancer may be diagnosed concurrently with pregnancy in approximately 0.1% of pregnancies. Sarcoma in pregnancy is even rarer. Most of the literature is in the form of case reports and literature reviews. With this background we decided to identify and review our experience with sarcomas diagnosed during pregnancy. Methods: We used our tumor registry records to identify patients who were either diagnosed or referred with a diagnosis of sarcoma during pregnancy. Data were collected on maternal age, gestational age at diagnosis of malignancy, management of pregnancy as well as sarcoma and maternal and fetal outcomes. Additional data on diagnostic work-up where done and available were also recorded. Results: We identified a total of 14 patients from 1991–2002. Median age of 14 patients included in this study was 27 years (range 15–39). The diagnoses included osteosarcoma (5), Rhabdomyosarcoma (2), Liposarcoma (2), Ewing’s Sarcoma (2), Chondrosarcoma (1), High Grade Sarcoma NOS (1), High Grade Spindle Cell Sarcoma (1). Five were diagnosed during first trimester, one during 3^rd and 7 during 2^nd trimester (data unknown in one patient). Only three patients underwent chemotherapy during pregnancy, 2-during 2nd trimester, and 1 during 3^rd trimester. One received VAIA for Ewing’s Sarcoma and the other Adriamycin for rhabdomyosarcoma. Both developed intrauterine fetal distress and delivered either spontaneously or via cesarean section with immediate neonatal death. The fetus exposed to VAIA was malformed. Overall fetal loss was documented either as therapeutic decision or complication of therapy in 7 patients, while 5 delivered normal healthy babies and data was not known in 2. Six patients were alive at last follow-up without evidence of disease, 4 had died of sarcoma or complication of treatment, 3 were alive with disease and one was lost to follow-up. Conclusions: Prognosis for fetus as well as mother is adversely affected by diagnosis of sarcoma during pregnancy. Administration of chemotherapy generally considered safe during 2^nd trimester may result in fetal distress and demise and should be undertaken cautiously. Since long-term survival may be achieved, management should be with a multi-disciplinary approach with involvement of mother in all decision making.

No significant financial relationships to disclose.

Abstract presentation from the 2005 ASCO Annual Meeting