Skip to main content

Advertisement

Log in

Oncological outcome of peripartum colorectal carcinoma—a single-center experience

  • Original Article
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Objectives

This study aimed to analyze disease presentation, management, and oncological outcomes of patients diagnosed with peripartum colorectal cancer (CRC).

Methods

Retrospective cohort study of all consecutive women of childbearing age (18–45 years) between 2002 and 2014 diagnosed with CRC adenocarcinoma at a tertiary academic institution. Patients who experienced pregnancy within 12 months of their diagnosis (peripartum period, group 1) were compared to the remaining patients of the cohort (group 2). Overall survival (OS) was compared between the two groups through Kaplan-Meier estimates.

Results

Out of 555 consecutive women with a mean age of 37.8 + 6 years, 31 (5.6%) were diagnosed with CRC in the peripartum period. Of these, all patients were symptomatic during pregnancy due to bleeding, abdominal pain, or constipation; however, only 11 CRC (35.5%) were diagnosed during pregnancy, 1 (3.2%) during C section, and the remaining (61.3%) postpartum. TNM stage at presentation was I in 6 patients (19.4%), II in 4 patients (13.9%), III in 8 patients (25.8%), and IV in 13 patients (41.9%). Surgical resection was performed in 23 patients (74.2%): 2 while pregnant, 2 at the time of C section, and the remainder postpartum. Across all stages, OS was 95% at 1 year and 62% at 5 years and did not differ between the two comparative groups (p = 0.16).

Conclusions

A suspicious attitude towards cancer-related symptoms during pregnancy is crucial to prevent delayed evaluation for CRC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Pavlidis NA (2002) Coexistence of pregnancy and malignancy. Oncologist 7(4):279–287

    PubMed  Google Scholar 

  2. Lee YY, Roberts CL, Dobbins T, Stavrou E, Black K, Morris J, Young J (2012) Incidence and outcomes of pregnancy-associated cancer in Australia, 1994–2008: a population-based linkage study. BJOG 119(13):1572–1582. https://doi.org/10.1111/j.1471-0528.2012.03475.x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Van Calsteren K, Heyns L, De Smet F, Van Eycken L, Gziri MM, Van Gemert W, Halaska M, Vergote I, Ottevanger N, Amant F (2010) Cancer during pregnancy: an analysis of 215 patients emphasizing the obstetrical and the neonatal outcomes. J Clin Oncol 28(4):683–689. https://doi.org/10.1200/JCO.2009.23.2801

    Article  PubMed  Google Scholar 

  4. Albright CM, Wenstrom KD (2016) Malignancies in pregnancy. Best Pract Res Clin Obstet Gynaecol 33:2–18. https://doi.org/10.1016/j.bpobgyn.2015.10.004

    Article  PubMed  Google Scholar 

  5. Saif MW (2005) Management of colorectal cancer in pregnancy: a multimodality approach. Clin Colorectal Cancer 5(4):247–256

    Article  PubMed  Google Scholar 

  6. Mechery J, Ikhena SE (2007) Cancer of the descending colon during pregnancy. J Obstet Gynaecol 27(3):311–312. https://doi.org/10.1080/01443610701241159

    Article  CAS  PubMed  Google Scholar 

  7. Smith LH, Danielsen B, Allen ME, Cress R (2003) Cancer associated with obstetric delivery: results of linkage with the California cancer registry. Am J Obstet Gynecol 189(4):1128–1135

    Article  PubMed  Google Scholar 

  8. Rogers JE, Dasari A, Eng C (2016) The treatment of colorectal cancer during pregnancy: cytotoxic chemotherapy and targeted therapy challenges. Oncologist 21(5):563–570. https://doi.org/10.1634/theoncologist.2015-0362

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Koren G, Carey N, Gagnon R, Maxwell C, Nulman I, Senikas V (2013) Cancer chemotherapy and pregnancy. J Obstet Gynaecol Can 35(3):263–278. https://doi.org/10.1016/S1701-2163(15)30999-3

    Article  PubMed  Google Scholar 

  10. Benard F, Barkun AN, Martel M, von Renteln D (2018) Systematic review of colorectal cancer screening guidelines for average-risk adults: summarizing the current global recommendations. World J Gastroenterol 24(1):124–138. https://doi.org/10.3748/wjg.v24.i1.124

    Article  PubMed  PubMed Central  Google Scholar 

  11. Staroselsky A, Nava-Ocampo AA, Vohra S, Koren G (2008) Hemorrhoids in pregnancy. Can Fam Physician 54(2):189–190

    PubMed  PubMed Central  Google Scholar 

  12. Dahling MT, Xing G, Cress R, Danielsen B, Smith LH (2009) Pregnancy-associated colon and rectal cancer: perinatal and cancer outcomes. J Matern Fetal Neonatal Med 22(3):204–211. https://doi.org/10.1080/14767050802559111

    Article  PubMed  Google Scholar 

  13. Kocian P, de Haan J, Cardonick EH, Uzan C, Lok CAR, Fruscio R, Halaska MJ, Amant F (2018) Writing Committee of the International Network on Cancer I, Pregnancy on this particular m (2018) Management and outcome of colorectal cancer during pregnancy: report of 41 cases. Acta Chir Belg:1–10. https://doi.org/10.1080/00015458.2018.1493821

  14. Chan YM, Ngai SW, Lao TT (1999) Colon cancer in pregnancy. A case report. J Reprod Med 44(8):733–736

    CAS  PubMed  Google Scholar 

  15. Robson DE, Lewin J, Cheng AW, O'Rourke NA, Cavallucci DJ (2017) Synchronous colorectal liver metastases in pregnancy and post-partum. ANZ J Surg 87(10):800–804. https://doi.org/10.1111/ans.13196

    Article  PubMed  Google Scholar 

  16. Edge SB, Compton CC (2010) The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 17(6):1471–1474. https://doi.org/10.1245/s10434-010-0985-4

    Article  Google Scholar 

  17. Dozois EJ, Boardman LA, Suwanthanma W, Limburg PJ, Cima RR, Bakken JL, Vierkant RA, Aakre JA, Larson DW (2008) Young-onset colorectal cancer in patients with no known genetic predisposition: can we increase early recognition and improve outcome? Medicine (Baltimore) 87(5):259–263. https://doi.org/10.1097/MD.0b013e3181881354

    Article  Google Scholar 

  18. Ye W, Tang Y, Yao C, Shi J, Xu Y, Jiang J (2017) Advanced gastrointestinal carcinoma with massive ascites and hydrothorax during pregnancy: a case report and review of the literature. Medicine (Baltimore) 96(51):e9354. https://doi.org/10.1097/MD.0000000000009354

    Article  Google Scholar 

  19. Hojgaard HM, Rahr H (2012) Rectal cancer in a pregnant woman, a case report. Ugeskr Laeger 174(26):1827–1828

    PubMed  Google Scholar 

  20. de Haan J, Verheecke M, Van Calsteren K, Van Calster B, Shmakov RG, Mhallem Gziri M, Halaska MJ, Fruscio R, Lok CAR, Boere IA, Zola P, Ottevanger PB, de Groot CJM, Peccatori FA, Dahl Steffensen K, Cardonick EH, Polushkina E, Rob L, Ceppi L, Sukhikh GT, Han SN, Amant F, International Network on C, Infertility P (2018) Oncological management and obstetric and neonatal outcomes for women diagnosed with cancer during pregnancy: a 20-year international cohort study of 1170 patients. Lancet Oncol 19(3):337–346. https://doi.org/10.1016/S1470-2045(18)30059-7

    Article  PubMed  Google Scholar 

  21. Pellino G, Simillis C, Kontovounisios C, Baird DL, Nikolaou S, Warren O, Tekkis PP, Rasheed S (2017) Colorectal cancer diagnosed during pregnancy: systematic review and treatment pathways. Eur J Gastroenterol Hepatol 29(7):743–753. https://doi.org/10.1097/MEG.0000000000000863

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Fabian Grass was supported by the Société Académique Vaudoise, Lausanne, Switzerland, and by the SICPA Foundation, Lausanne, Switzerland.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kellie L. Mathis.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Grass, F., Spindler, B.A., Naik, N.D. et al. Oncological outcome of peripartum colorectal carcinoma—a single-center experience. Int J Colorectal Dis 34, 899–904 (2019). https://doi.org/10.1007/s00384-019-03278-2

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-019-03278-2

Keywords

Navigation