Cervical carcinoma and pregnancy.

Abortion and conization of the cervix is the treatment of choice for patients with preinvasive cervical carcinoma combined with first-term pregnancy. With the second and third term, the pregnancy is led to delivery and a secondary examination is carried out. In case of preienvasive carcinoma only conization of the cervix is performed. In late-term pregnancy the surgical operation starts with a cesarean section. A combination of cervical carcinoma and pregnancy was observed in 31 (44%) of 6,890 patients admitted to the Gynecological Clinic of the National Cancer Center from 1964-2001. Of 1,911 patients with radical hysterectomy (Stage I--58.4%, Stage II--21.8%, Stage III--20%) a combination of cervical carcinoma and pregnancy was diagnosed in 31 women [Stage I--23 (74.2%), Stage II--4 (12.9%), Stage III--4 (12.9%)]; 93.5% of the patients had a first or second term pregnancy. Five-year survival of the patients with surgery only was 83.3%, while with combined therapy--60%. Twenty-nine percent of the patients were 30 and younger. Pregnancy contributed to early manifestation of cervical cancer and did not favor the aggression of malignant tumor growth. The five-year survival rate of patients without staging and those combined with pregnancy was 72.7%; five-year survival rate of patients with early pregnancy was worse compared to those with second or third term pregnancies. Pregnancy is not a contraindication for performance of radical hysterectomy.

The management of cervical cancer in the experience of oncological institute of Tbilisi.

The Authors, after a brief review of epidemiological patterns in the USSR, describe their own experience in the management of cervical cancer. Out of 5116 patients observed in Tbilisi Oncological Center in 26 years (1964-1989), 1289 women (25.7%) underwent radical surgical operation. The other patients received combined Radiotherapy (Brachytherapy plus Teletherapy). In stage I B the best results were obtained with Surgery (5 year survival 86%). Treatment results in stage II (5 year survival rate 68.2%) were obtained with combined Surgery and Radiotherapy. Overall 5 year survival in stage III was 39.3% and treatment results were directly correlated with primary tumour characteristics.