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 21 October 2017

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News

Colorectal cancer diagnosed during pregnancy

The most recent issue of the European Journal of Gastroenterology identifies the mode of presentation and incidence of colorectal cancer in pregnancy.

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Dr Shahnawaza Rasheed and colleagues identified the mode of presentation and incidence of colorectal cancer in pregnancy.

The researchers assessed the outcomes of the mother and fetus according to gestational age, treatment delivered and cancer features and location.

The team performed a systematic review of the literature to identify studies reporting on colorectal cancer in pregnancy and pooled analysis of the reported data.

The researchers identified 79 papers reporting on 119 patients with unequivocal colorectal cancer in pregnancy were included.

The team found that the calculated pooled risk was less than 1%, and age at diagnosis has decreased over time.

The median age at diagnosis was 32 years.

The research team noted that 12%, 41% and 47% of colorectal cancer in pregnancy were diagnosed during the first, second and third trimester.

The colorectal cancer in pregnancy site was the colon in 53% of cases, the rectum in 44% and multiple sites in 3%.

The researchers noted that bleeding occurred in 47% of patients, abdominal pain in 38%, constipation in 14%, obstruction in 9% and perforation in 2%.

Out of 82 patients whose treatment was described, 10% received chemotherapy during pregnancy.

The colorectal cancer in pregnancy site was the colon in 53% of cases
European Journal of Gastroenterology

None of their newborns developed permanent disability, one developed hypothyroidism and 72% of newborns were alive.

The research team reported that vaginal delivery was possible in 60% of cases.

Anterior resection was performed in 30% of patients and abdominoperineal excision of the rectum in 15%.

The researchers observed that 5 patients had either synchronous or metachronous liver resection.

The median survival in these patients was 42 months.

The research team found that 55% of patients were alive at the last available follow-up.

The median survival of the mother was 36 months.

The team noted that patients with rectal cancer had longer survival compared with patients with colon cancer.

Dr Rasheed's team concludes, "Colorectal cancer in pregnancy is rare, leading to symptoms being overlooked, and diagnosis made at advanced stages."

"Cases described in the literature include patients who had cancer before pregnancy or developed it after delivery."

"Survival has not increased over time and the management of these patients requires collaboration between specialties and active interaction with the patients."

Eur J Gastroenterol Hepatol 2017: 29(7): 743–753
13 June 2017

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