Radical hysterectomy after cesarean





Cesarean; Pregnancy; Hysterectomy; Cervical neoplasms; Childbirth.


Introduction: Cervical cancer diagnosed during pregnancy is uncommon, and there are risk factors for this condition, such as lack of access to health services and failure to perform the recommended screening for early diagnosis of precursor lesions of cervical cancer. cervix. In young patients with fetal maturation, the treatment is radical hysterectomy with bilateral pelvic lymphnodenectomy, preceded by cesarean section. We report on a 33-year-old female patient who was diagnosed with an early-stage invasive squamous cell carcinoma in the course of a 26-week pregnancy. After discussion with the couple, it was decided to wait for fetal maturation and the pregnancy would be terminated at the 36th week by cesarean section, followed by radical hysterectomy and bilateral pelvic lymphadenectomy. Methods: This is a retrospective, cross-sectional, qualitative and descriptive observational study. This work was approved by the Research Ethics Committee of the State University of Piauí, with CAAE n. 30154720.0.0000.5209. Final considerations: The case reported and the publications found in the literature show agreement on the possibility of having a peaceful pregnancy with cervical carcinoma without harm to the fetus if follow-up and adequate treatment are carried out. Although both surgical treatment and local and systemic treatment have advantages and disadvantages, both for the fetus and for the mother, it is necessary to have a multidisciplinary team available so that, according to the individuality of the case, follow-up can be carried out. and help in making the best decision for the maternal-fetal set, the case reported and publications raised show that it is possible to have a peaceful pregnancy with cervical carcinoma without harm to the fetus if follow-up and adequate treatment are carried out.


Amant, F., Halaska, M. J., Fumagalli, M., Dahl Steffensen, K., Lok, C., Van Calsteren, K., Han, S. N., Mir, O., Fruscio, R., Uzan, C., Maxwell, C., Dekrem, J., Strauven, G., Mhallem Gziri, M., Kesic, V., Berveiller, P., van den Heuvel, F., Ottevanger, P. B., Vergote, I., & Lishner, M. (2014). ESGO task force ‘Cancer in Pregnancy’. Official Journal of the International Gynecological Cancer Society, 24(3), 394-403. doi:10.1097/IGC.0000000000000062.

Botha, M. H., Rajaram, S., & Karunaratne, K. (2018). Cancer in pregnancy. International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics, 143(2), 137-142. doi:10.1002/ijgo.12621.

Cook-Glenn, C. L., & Keyhani-Rofagha, S. (1998). Adenocarcinoma of the uterine cervix associated with pregnancy: a retrospective 10-year investigative study. Diagnostic Cytopathology, 18(6), 393-397. doi:10.1002/(sici)1097-0339(199806)18:6<393::aid-dc2>3.0.co;2-a.

Gungorduk, K., Sahbaz, A., Ozdemir, A., Gokcu, M., Sancı, M., & Köse, M. F. (2016). Management of cervical cancer during pregnancy. Journal of Obstetrics and Gynaecology: the journal of the Institute of Obstetrics and Gynaecology, 36(3), 366-371. doi:10.3109/01443615.2015.1065235.

Hacker, N. F. (2005). Practical Gynecologic Oncology. Philadelphia: Williams & Wilkins.

Hopkins, M. P., & Morley, G. W. (1992). The prognosis and management of cervical cancer associated with pregnancy. Obstetrics and Gynecology, 80(1), 9-13. Retrieved from: https://europepmc.org/article/med/1318532.

Korenaga, T. K., & Tewari, K. S. (2020). Gynecologic cancer in pregnancy. Gynecologic Oncology, 157(3), 799-809. doi:10.1016/j.ygyno.2020.03.015.

Lee, J. M., Lee, K. B., Kim, Y. T., Ryu, H. S., Kim, Y. T., Cho, C. H., Namkoong, S. E., Lee, K. H., Choi, H. S., & Kim, K. T. (2008). Cervical cancer associated with pregnancy: results of a multicenter retrospective Korean study (KGOG-1006). American Journal of Obstetrics and Gynecology, 198(1), 92.e1-92.e926. doi:10.1016/j.ajog.2007.06.077.

Method, M. W., & Brost, B. C. (1999). Management of cervical cancer in pregnancy. Seminars in Surgical Oncology, 16(3), 251-260. doi:10.1002/(sici)1098-2388(199904/05)16:3<251::aid-ssu11>3.0.co;2-4.

Monk, B. J., & Montz, F. J. (1992). Invasive cervical cancer complicating intrauterine pregnancy: treatment with radical hysterectomy. Obstetrics and Gynecology, 80(2), 199-203. Retrieved from: https://journals.lww.com/greenjournal/Abstract/1992/08000/Invasive_Cervical_Cancer_Complicating_Intrauterine.9.aspx.

Nguyen, C., Montz, F. J., & Bristow, R. E. (2000). Management of stage I cervical cancer in pregnancy. Obstetrical & Gynecological Survey, 55(10), 633-643. doi:10.1097/00006254-200010000-00022.

Palaia, I., Pernice, M., Graziano, M., Bellati, F., & Panici, P. B. (2007). Neoadjuvant chemotherapy plus radical surgery in locally advanced cervical cancer during pregnancy: a case report. American Journal of Obstetrics and Gynecology, 197(4), e5-e6. doi:10.1016/j.ajog.2007.07.034.

Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia da Pesquisa Científica. Santa Maria: UAB/NTE/UFMS.

Ramirez, P. T., Abu-Rustum, N. R., & Euscher, E. (2019). Conservative management of cervical cancer in pregnancy. International Journal of Gynecological Cancer: official journal of the International Gynecological Cancer Society, 29(2), 434-438. doi:10.1136/ijgc-2018-000187.

Schreiber, K., Rothe, S., & Untch, M. (2014). Cervical Carcinoma in Early Pregnancy - Successful Birth by Caesarean Section Followed by Radical Hysterectomy. Geburtshilfe und Frauenheilkunde, 74(3), 284-287. doi:10.1055/s-0033-1360329.

Sood, A. K., Sorosky, J. I., Krogman, S., Anderson, B., Benda, J., & Buller, R. E. (1996). Surgical management of cervical cancer complicating pregnancy: a case-control study. Gynecologic Oncology, 63(3), 294-298. doi:10.1006/gyno.1996.0325.

Tewari, K., Cappuccini, F., Gambino, A., Kohler, M. F., Pecorelli, S., & DiSaia, P. J. (1998). Neoadjuvant chemotherapy in the treatment of locally advanced cervical carcinoma in pregnancy: a report of two cases and review of issues specific to the management of cervical carcinoma in pregnancy including planned delay of therapy. Cancer, 82(8), 1529-1534. doi:10.1002/(sici)1097-0142(19980415)82:8<1529::aid-cncr15>3.0.co;2-6.

Vieira, S. C., Silva, A. G., Vale, L. R. G., & Lima, M. M. (2002). Preservação dos ovários em cirurgia radical para câncer do colo uterino. [Ovarian preservation in radical surgery for cervical cancer]. Revista Brasileira de Ginecologia e Obstetrícia, 24(10), 681-684. doi:10.1590/S0100-72032002001000008.

Watanabe, Y., Tsuritani, M., Kataoka, T., Kanemura, K., Shiina, M., Ueda, H., & Hoshiai, H. (2009). Radical hysterectomy for invasive cervical cancer during pregnancy: a retrospective analysis of a single institution experience. European Journal of Gynaecological Oncology, 30(1), 79-81. Retrieved from: https://europepmc.org/article/med/19317263.

Weisz, B., Schiff, E., & Lishner, M. (2001). Cancer in pregnancy: maternal and fetal implications. Human Reproduction Update, 7(4), 384-393. doi:10.1093/humupd/7.4.384.

Zagouri, F., Dimitrakakis, C., Marinopoulos, S., Tsigginou, A., & Dimopoulos, M. A. (2016). Cancer in pregnancy: disentangling treatment modalities. ESMO Open, 1(3), e000016. doi:10.1136/esmoopen-2015-000016.



How to Cite

CASTRO, L. M. F. de; TAJRA, C. de P.; VIEIRA, S. C. Radical hysterectomy after cesarean. Research, Society and Development, [S. l.], v. 11, n. 3, p. e53711327074, 2022. DOI: 10.33448/rsd-v11i3.27074. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/27074. Acesso em: 15 jun. 2024.



Health Sciences