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Kanser tedavisi sonrası sağ kalım sürecindeki gebelik olguları; tek tersiyer merkezin deneyimi

Yıl 2017, Cilt: 80 Sayı: 3, 98 - 103, 01.09.2017
https://doi.org/10.18017/iuitfd.363576

Öz

Amaç: Genç adolesan ve yetişkin dönemde
kanser tedavisi gören kadınların gebeliklerini analiz edip obstetrik ve
neonatal sonuçlarını değerlendirmektir.

Gereç ve Yöntem: Cerrahpaşa Tıp Fakültesi
Kadın Hastalıkları ve Doğum Kliniği
nde Ocak
2000-Aralık 2015 yılları arasında antenatal izlemi yapılan, adolesan ve genç
erişkin dönemde kanser tedavisi görmüş ve izlem sürecinde gebe kalan 68 olgunun
maternal ve perinatal sonuçları, retrospektif olarak değerlendirildi. Kanser
tiplerinin dağılımı, kanser tanısının konulduğu yaş, uygulanan tedavi ve izlem
süresi irdelendi. Maternal sonuçlar; doğum haftası, doğum kilosu ve perinatal
sonuçlar değerlendirildi.

Bulgular: En sık karşılaşılan kanserler,
tiroid kanseri (%26,5), hematolojik maligniteler (%22,5) ve genital kanserler
(%18) olarak saptandı. Olguların ortalama yaşı 31,7
±5,5
ve nulliparite oranı %48,5 olarak saptandı. Ortalama doğum haftası 37,5
±2,5; ortalama doğum kilosu 3020±717,
37 hafta öncesinde doğum oranı %12,1 iken 34 hafta öncesinde doğum oranı %8,8
olarak tespit edildi. Grubumuzda sezaryen, fetal gelişim kısıtlılığı,
preeklampsi ve gestasyonel diayabet oranları sırasıyla %77,2, %5,8, %2,9 ve
%8,8 olarak belirlendi. 2 hastada abortus izlenirken, 3 hastaya tıbbi nedenli
tahliye yapıldı. Kansere yakalanma yaş ortalaması en düşük hematolojik
kanserlerde gözlenirken (22,5
±6,6) sonrasında iskelet sistemi (26±8,7) ve tiroid kanseri (26,9±5,6) yer aldı.
Hastaların hiçbirinde konjenital fetal anomali izlenmedi.







Sonuç: Kanser tedavisi sonrası gebe kalan
hasta grubunda olumlu obstetrik sonuçlar gözlenmiş olup, bu hastaların gebelik
izlemi, uygun merkezlerde, multidisipliner bir ekiple yapılmalıdır.

Kaynakça

  • 1. Barr RD. Adolescents, young adults, and cancer-the international challenge. Cancer 2011;117Suppl 10):2245-9.
  • 2. McVie JG. Cancer treatment: the last 25 years. Cancer Treat Rev 1999;25(6):323-31.
  • 3. Hawkins MM, Smith RA, Curtice LJ. Childhood cancer survivors and their offspring studied through a postal survey of general practitioners: preliminary results. J R Coll Gen Pract 1988;38(308):102-5.
  • 4. Byrne J, Rasmussen SA, Steinhorn SC, Connelly RR, Myers MH, Lynch CF, et al. Genetic disease in offspring of long-term sur- vivors of childhood and adolescent cancer. Am J Hum Genet 1998;62(1):45-52.
  • 5. Green DM, Zevon MA, Lowrie G, Siegelstein N, Hall B. Congenital anomalies in children of patients who received chemotherapy for cancer in childhood and adolescence. N Engl J Med 1991;325(3):141-5.
  • 6. Green DM, Fiorello A, Zevon MA, Hall B, Siegelstein N. Birth defects and childhood cancer in offspring of survivors of childhood cancer. Arch Pediatr Adolesc Med 1997;151(4):379-83.
  • 7. Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, Petkov VI, et al. SEER Cancer Statistics Review 1975–2008. 2011; Bethesda, MD: National Cancer Institute.
  • 8. Green DM, Whitton JA, Stovall M, Mertens AC, Donaldson SS, Ruyman FB, et al. Pregnancy outcome of female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. Am J Obstet Gynecol 2002;187(4):1070-80.
  • 9. Signorello LB, Cohen SS, Bosetti C. Female survivors of childhood cancer: preterm birth and low birth weight among their children. J Natl Cancer Inst 2006;98(20):1453-61.
  • 10. Madanat-Harjuoja LM, Malila N, Lähteenmäki PM, Boice JD, Gissler M, Dyba T. Preterm delivery among female survivors of childhood, adolescent and young adulthood cancer. Int J Cancer 2010;127(7):1669-79.
  • 11. Magelssen H, Melve KK, Skjaerven R, Fossa SD. Parenthood probability and pregnancy outcome in patients with a cancer diagnosis during adolescence and young adulthood. Hum Reprod 2008;23(1):178-86.
  • 12. Dalgberg K, Eriksson J, Holmberg L. Birth outcome in women with previously treated breast cancer-a population-based cohort study from Sweden. PLoS Med 2006;3(9):336.
  • 13. Langagergaard V, Gislum M, Skriver MV, Norgard B, Lash TL, Rothman KJ, et al. Birth outcome in women with breast cancer. Br J Cancer 2006;94(1):142-6.
  • 14. Langagergaard V, Puho EH, Lash TL, Norgard B, Sorensen HT. Birth outcome in Danish women with cutaneous malignant melanoma. Melanoma Res 2007;17(1):31-6.
  • 15. Haggar FA, Pereira G, Preen D, Holman CD, Einersdotti K. Adverse Obstetric and Perinatal Outcomes following Treatment of Adolescent and Young Adult Cancer: A Population-Based Cohort Study 2014;9:e113292.
  • 16. Stensheim H, Moller B, van DT, Fossa SD. Cause-specific survival for women diagnosed with cancer during pregnancy or lactation: a registry-based cohort study. J Clin Oncol 2009;27:45-51.
  • 17. Kim J, Mersereau JE, Su HI, Whitcomb BW, Malcarne VL, Gorman JR. Young female cancer survivors’ use of fertility care after completing cancer treatment. Support Care Cancer 2016;24(7):3191-9.
  • 18. Stensheim H, Klungsory K, Skjaerven R, Grotmol T, Fossa S. Birth outcomes among offspring of adult cancer survivors: A population based study. Int J Cancer 2013;133(11):2696-705.
  • 19. Li FP, Fine W, Jaffe N, Holmes GE, Holmes FF. Offspring of patients treated for cancer in childhood. J Natl Cancer Inst 1979;62(5):1193-7.
  • 20. Green DM, Zevon MA, Lowrie G, Siegelstein N, Hall B. Congenital anomalies in children of patients who received chemotherapy for cancer in childhood and adolescence. N Engl J Med 1991;325(3):141-5.
  • 21. Green DM, Fine WE, Li FP. Offspring of patients treated for unilateral Wilms’ tumor in childhood. Cancer 1982;49(11):2285-8.
  • 22. Byrne J, Mulvihill JJ, Connelly RR, Austin DA, Holmes GE, Holmes FF, et al. Reproductive problems and birth defects in survivors of Wilms’ tumor and their relatives. Med Pediatr Oncol 1988;16(4):233-40.
  • 23. Li FP, Gimbrere K, Gelber RD, Sallan SE, Flamant F, Green DM, et al. Outcome of pregnancy in survivors of Wilms’ tumor. JAMA 1987;257(2):216-9.
  • 24. Chiarelli A, Marret L, Darlington G. Pregnancy outcomes in females after treatment for childhood cancer. Epidemiology 2000;11(2):161-6.
  • 25. Van Calsteren K, Amant F. Cancer during pregnancy. Acta Obstet Gynecol Scand 2014;93(5):443-6.
  • 26. Cardonick E, Iacobucci A. Use of chemotherapy during human pregnancy. Lancet Oncol 2004;5(5):283-91.
  • 27. Van Calsteren K, Heyns L, De Smet F, Van Eycken L, Gziri MM, Van Gemert W, et al. Cancer during pregnancy: an analysis of 215 patients emphasizing the obstetrical and the neonatal outcomes. J Clin Oncol 2010;28(4):683-9.

Pregnancy in cancer survivors; experience of a single tertiary center

Yıl 2017, Cilt: 80 Sayı: 3, 98 - 103, 01.09.2017
https://doi.org/10.18017/iuitfd.363576

Öz

Objective: To investigate obstetric and
perinatal outcomes among pregnant female survivors of adolescent and young adult
cancers.

Materials and Methods: A retrospective
analysis of maternal and perinatal outcomes of 68 pregnant women with a history
of cancer who received antenatal care at the Cerrahpasa Medical Faculty
Obstetric and Gynecology Department between January 2000 and  December 2015 was carried out. Perinatal and
maternal outcomes were evaluated according to cancer type, timing of cancer
diagnosis, and treatment modality. The distribution of cancer types, the age at
which the cancer was diagnosed, the treatment modalities, and the duration of
follow-up were analyzed. Maternal and perinatal outcomes were evaluated.





Results: The most
frequently encountered tumor types in pregnant women with a history of cancer
were thyroid cancers (26.5%), hematologic malignancies (22.5%), and genital
cancers (18%). The mean maternal age was 31.7±5.5 years, and the frequency of
nulliparity was 48.5%. The mean gestational age at delivery was 37.5±2.5 weeks,
the mean birth weight was 3020±717 g, and the frequencies of delivery before 37
and 34 weeks were 12.1% and 8.8%, respectively. The incidences of ceaserian
section, fetal growth restriction, preeclampsia, and gestational diabetes were
77.2%, 5.8%, 2.9%, and 8.8%, respectively, in women with a history of cancer.
There were two miscarriages and three terminations of pregnancy in women who
had survived cancer. The lowest mean age at the time of cancer diagnosis was
observed for haematological cancers (22.5±6.6). There were no congenital
anomalies in our group.


Conclusion: Cancer survivors who became
pregnant after cancer treatment had good obstetric outcomes. Pregnancy
follow-up of these patients should be carried out by a multidisciplinary team
at tertiary centers.

Kaynakça

  • 1. Barr RD. Adolescents, young adults, and cancer-the international challenge. Cancer 2011;117Suppl 10):2245-9.
  • 2. McVie JG. Cancer treatment: the last 25 years. Cancer Treat Rev 1999;25(6):323-31.
  • 3. Hawkins MM, Smith RA, Curtice LJ. Childhood cancer survivors and their offspring studied through a postal survey of general practitioners: preliminary results. J R Coll Gen Pract 1988;38(308):102-5.
  • 4. Byrne J, Rasmussen SA, Steinhorn SC, Connelly RR, Myers MH, Lynch CF, et al. Genetic disease in offspring of long-term sur- vivors of childhood and adolescent cancer. Am J Hum Genet 1998;62(1):45-52.
  • 5. Green DM, Zevon MA, Lowrie G, Siegelstein N, Hall B. Congenital anomalies in children of patients who received chemotherapy for cancer in childhood and adolescence. N Engl J Med 1991;325(3):141-5.
  • 6. Green DM, Fiorello A, Zevon MA, Hall B, Siegelstein N. Birth defects and childhood cancer in offspring of survivors of childhood cancer. Arch Pediatr Adolesc Med 1997;151(4):379-83.
  • 7. Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, Petkov VI, et al. SEER Cancer Statistics Review 1975–2008. 2011; Bethesda, MD: National Cancer Institute.
  • 8. Green DM, Whitton JA, Stovall M, Mertens AC, Donaldson SS, Ruyman FB, et al. Pregnancy outcome of female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. Am J Obstet Gynecol 2002;187(4):1070-80.
  • 9. Signorello LB, Cohen SS, Bosetti C. Female survivors of childhood cancer: preterm birth and low birth weight among their children. J Natl Cancer Inst 2006;98(20):1453-61.
  • 10. Madanat-Harjuoja LM, Malila N, Lähteenmäki PM, Boice JD, Gissler M, Dyba T. Preterm delivery among female survivors of childhood, adolescent and young adulthood cancer. Int J Cancer 2010;127(7):1669-79.
  • 11. Magelssen H, Melve KK, Skjaerven R, Fossa SD. Parenthood probability and pregnancy outcome in patients with a cancer diagnosis during adolescence and young adulthood. Hum Reprod 2008;23(1):178-86.
  • 12. Dalgberg K, Eriksson J, Holmberg L. Birth outcome in women with previously treated breast cancer-a population-based cohort study from Sweden. PLoS Med 2006;3(9):336.
  • 13. Langagergaard V, Gislum M, Skriver MV, Norgard B, Lash TL, Rothman KJ, et al. Birth outcome in women with breast cancer. Br J Cancer 2006;94(1):142-6.
  • 14. Langagergaard V, Puho EH, Lash TL, Norgard B, Sorensen HT. Birth outcome in Danish women with cutaneous malignant melanoma. Melanoma Res 2007;17(1):31-6.
  • 15. Haggar FA, Pereira G, Preen D, Holman CD, Einersdotti K. Adverse Obstetric and Perinatal Outcomes following Treatment of Adolescent and Young Adult Cancer: A Population-Based Cohort Study 2014;9:e113292.
  • 16. Stensheim H, Moller B, van DT, Fossa SD. Cause-specific survival for women diagnosed with cancer during pregnancy or lactation: a registry-based cohort study. J Clin Oncol 2009;27:45-51.
  • 17. Kim J, Mersereau JE, Su HI, Whitcomb BW, Malcarne VL, Gorman JR. Young female cancer survivors’ use of fertility care after completing cancer treatment. Support Care Cancer 2016;24(7):3191-9.
  • 18. Stensheim H, Klungsory K, Skjaerven R, Grotmol T, Fossa S. Birth outcomes among offspring of adult cancer survivors: A population based study. Int J Cancer 2013;133(11):2696-705.
  • 19. Li FP, Fine W, Jaffe N, Holmes GE, Holmes FF. Offspring of patients treated for cancer in childhood. J Natl Cancer Inst 1979;62(5):1193-7.
  • 20. Green DM, Zevon MA, Lowrie G, Siegelstein N, Hall B. Congenital anomalies in children of patients who received chemotherapy for cancer in childhood and adolescence. N Engl J Med 1991;325(3):141-5.
  • 21. Green DM, Fine WE, Li FP. Offspring of patients treated for unilateral Wilms’ tumor in childhood. Cancer 1982;49(11):2285-8.
  • 22. Byrne J, Mulvihill JJ, Connelly RR, Austin DA, Holmes GE, Holmes FF, et al. Reproductive problems and birth defects in survivors of Wilms’ tumor and their relatives. Med Pediatr Oncol 1988;16(4):233-40.
  • 23. Li FP, Gimbrere K, Gelber RD, Sallan SE, Flamant F, Green DM, et al. Outcome of pregnancy in survivors of Wilms’ tumor. JAMA 1987;257(2):216-9.
  • 24. Chiarelli A, Marret L, Darlington G. Pregnancy outcomes in females after treatment for childhood cancer. Epidemiology 2000;11(2):161-6.
  • 25. Van Calsteren K, Amant F. Cancer during pregnancy. Acta Obstet Gynecol Scand 2014;93(5):443-6.
  • 26. Cardonick E, Iacobucci A. Use of chemotherapy during human pregnancy. Lancet Oncol 2004;5(5):283-91.
  • 27. Van Calsteren K, Heyns L, De Smet F, Van Eycken L, Gziri MM, Van Gemert W, et al. Cancer during pregnancy: an analysis of 215 patients emphasizing the obstetrical and the neonatal outcomes. J Clin Oncol 2010;28(4):683-9.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Konular Sağlık Kurumları Yönetimi
Bölüm Klinik Araştırma
Yazarlar

Ebru Alıcı Davutoğlu

Ayşegül Özel

Rıza Madazlı Bu kişi benim

Yayımlanma Tarihi 1 Eylül 2017
Gönderilme Tarihi 16 Ocak 2017
Yayımlandığı Sayı Yıl 2017 Cilt: 80 Sayı: 3

Kaynak Göster

APA Alıcı Davutoğlu, E., Özel, A., & Madazlı, R. (2017). Pregnancy in cancer survivors; experience of a single tertiary center. Journal of Istanbul Faculty of Medicine, 80(3), 98-103. https://doi.org/10.18017/iuitfd.363576
AMA Alıcı Davutoğlu E, Özel A, Madazlı R. Pregnancy in cancer survivors; experience of a single tertiary center. İst Tıp Fak Derg. Eylül 2017;80(3):98-103. doi:10.18017/iuitfd.363576
Chicago Alıcı Davutoğlu, Ebru, Ayşegül Özel, ve Rıza Madazlı. “Pregnancy in Cancer Survivors; Experience of a Single Tertiary Center”. Journal of Istanbul Faculty of Medicine 80, sy. 3 (Eylül 2017): 98-103. https://doi.org/10.18017/iuitfd.363576.
EndNote Alıcı Davutoğlu E, Özel A, Madazlı R (01 Eylül 2017) Pregnancy in cancer survivors; experience of a single tertiary center. Journal of Istanbul Faculty of Medicine 80 3 98–103.
IEEE E. Alıcı Davutoğlu, A. Özel, ve R. Madazlı, “Pregnancy in cancer survivors; experience of a single tertiary center”, İst Tıp Fak Derg, c. 80, sy. 3, ss. 98–103, 2017, doi: 10.18017/iuitfd.363576.
ISNAD Alıcı Davutoğlu, Ebru vd. “Pregnancy in Cancer Survivors; Experience of a Single Tertiary Center”. Journal of Istanbul Faculty of Medicine 80/3 (Eylül 2017), 98-103. https://doi.org/10.18017/iuitfd.363576.
JAMA Alıcı Davutoğlu E, Özel A, Madazlı R. Pregnancy in cancer survivors; experience of a single tertiary center. İst Tıp Fak Derg. 2017;80:98–103.
MLA Alıcı Davutoğlu, Ebru vd. “Pregnancy in Cancer Survivors; Experience of a Single Tertiary Center”. Journal of Istanbul Faculty of Medicine, c. 80, sy. 3, 2017, ss. 98-103, doi:10.18017/iuitfd.363576.
Vancouver Alıcı Davutoğlu E, Özel A, Madazlı R. Pregnancy in cancer survivors; experience of a single tertiary center. İst Tıp Fak Derg. 2017;80(3):98-103.

Contact information and address

Addressi: İ.Ü. İstanbul Tıp Fakültesi Dekanlığı, Turgut Özal Cad. 34093 Çapa, Fatih, İstanbul, TÜRKİYE

Email: itfdergisi@istanbul.edu.tr

Phone: +90 212 414 21 61