Pregnancy and Cancer: Special Considerations on Maternal and Fetal Implications

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Clinical Research of Cancer".

Deadline for manuscript submissions: closed (31 December 2024) | Viewed by 3381

Special Issue Editor


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Guest Editor
Department of Obstetrics and Gynecology, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
Interests: COVID in pregnancy; prenatal care; fetal medicine; colposcopy; medical law; gynecological oncology
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Special Issue Information

Dear Colleagues,

The Special Issue "Pregnancy and Cancer: Special Considerations on Maternal and Fetal Implications" delves into the complex intersection of cancer diagnosis and treatment during pregnancy. It explores the unique challenges faced by expectant mothers diagnosed with cancer and the implications for both maternal health and fetal development. We aim to cover topics such as the risks associated with various cancer treatments during pregnancy, the importance of multidisciplinary care involving oncologists and obstetricians, and the decision-making process regarding treatment options that balance maternal well-being with fetal safety. Additionally, we would like to touch upon the latest research advancements and guidelines aimed at optimizing outcomes for both mother and baby in these delicate situations emphasizing the need for careful risk assessment and shared decision-making to navigate the delicate balance between treating cancer effectively while minimizing risks to the pregnancy.

Prof. Dr. Liana Pleş
Guest Editor

Manuscript Submission Information

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Keywords

  • cancer
  • pregnancy
  • fetus
  • chemotherapy
  • radiotherapy
  • surgery
  • targeted therapy
  • immunotherapy

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Published Papers (3 papers)

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Review

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26 pages, 393 KiB  
Review
Diagnosis and Management of Cancers in Pregnancy: The Results of a Dual Battle Between Oncological Condition and Maternal Environment—Literature Review
by Mihai-Daniel Dinu, Romina-Marina Sima, Andrei-Sebastian Diaconescu, Mircea-Octavian Poenaru, Gabriel-Petre Gorecki, Mihaela Amza, Mihai Popescu, Mihai-Teodor Georgescu, Ancuta-Alina Constantin, Mara-Madalina Mihai, Cristian-Valentin Toma and Liana Ples
Cancers 2025, 17(3), 389; https://doi.org/10.3390/cancers17030389 - 24 Jan 2025
Viewed by 937
Abstract
Cancer during pregnancy presents considerable challenges that arise from various factors, including the diagnostic, prognostic and therapeutic implications of managing cancer in this unique patient population. There is a crucial need for an integrated approach that aligns medical interventions for both the pregnant [...] Read more.
Cancer during pregnancy presents considerable challenges that arise from various factors, including the diagnostic, prognostic and therapeutic implications of managing cancer in this unique patient population. There is a crucial need for an integrated approach that aligns medical interventions for both the pregnant patient and the developing embryo or fetus. Furthermore, the distinct characteristics associated with each stage of gestation may significantly influence the treatment protocols that can be proposed. Due to all of these factors, the importance of collaboration among healthcare professionals from different specialties (to ensure that both mother and child receive optimal care throughout the pregnancy) is often neglected. This review is designed to provide a thorough overview of the current standard procedures regarding the diagnosis and treatment options for cancer in pregnant patients in order to ensure the safety of mother and child. Furthermore, the review describes the feasibility of current fertility preservation methods, highlights the psychological effects of cancer during pregnancy and examines the risks and benefits of breastfeeding. Full article
18 pages, 307 KiB  
Review
Lymphangioleiomyomatosis and Pregnancy—Do We Have All the Answers for a Woman Who Desires to Conceive?—Literature Review
by Ancuta-Alina Constantin, Andreea Dumitrita Gaburici, Andreea Nicoleta Malaescu, Ana-Luiza Iorga, Christiana Diana Maria Dragosloveanu, Mircea-Octavian Poenaru, Gabriel-Petre Gorecki, Mihaela Amza, Mihai-Teodor Georgescu, Ramona-Elena Dragomir, Mihai Popescu and Romina-Marina Sima
Cancers 2025, 17(2), 323; https://doi.org/10.3390/cancers17020323 - 20 Jan 2025
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Abstract
Lymphangioleiomyomatosis (LAM) is a rare, progressive, and poor-prognosis systemic disorder that primarily affects women of reproductive age, with a higher prevalence among individuals of Caucasian origin. However, there are limited reliable data on the prevalence of LAM during pregnancy. The fulminant respiratory clinical [...] Read more.
Lymphangioleiomyomatosis (LAM) is a rare, progressive, and poor-prognosis systemic disorder that primarily affects women of reproductive age, with a higher prevalence among individuals of Caucasian origin. However, there are limited reliable data on the prevalence of LAM during pregnancy. The fulminant respiratory clinical presentation that often includes progressive dyspnea on exertion, cough, or hemoptysis, frequently complicated by pneumothorax, and the increased risk of spontaneous abortion due to increased estrogen and progesterone production during gestation, are arguments that most often make the diagnosed woman avoid pregnancy. Elevated levels of vascular endothelial growth factor D (VEGF-D), decline in respiratory function, and radiological findings are sufficient arguments in favor of the diagnosis in the pregnant woman. Sirolimus, an mTOR inhibitor, has demonstrated effectiveness in slowing the decline of lung function. Although sirolimus treatment is often recommended to be discontinued before conception due to the increased risk of fetal growth restriction, maintaining a dose level of <5 pcg/mL, with serum drug levels of 3–5 pcg/L, has been considered safe. Given the potential risks, individualized decisions about pregnancy are advised for patients with LAM. For those who choose to proceed, close monitoring by a multidisciplinary team is essential to manage complications effectively. Ongoing research aims to provide clearer guidance to optimize outcomes for both mother and child. Full article

Other

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12 pages, 549 KiB  
Systematic Review
Evaluating Offspring After Pregnancy-Associated Cancer: A Systematic Review of Neonatal Outcomes
by Aida Petca, Lucia Elena Niculae, Raluca Tocariu, Aniela-Roxana Nodiți, Răzvan-Cosmin Petca and Ioana Cristina Rotar
Cancers 2025, 17(2), 299; https://doi.org/10.3390/cancers17020299 - 17 Jan 2025
Viewed by 744
Abstract
Background/Objectives: Pregnancy-associated cancer (PAC) presents significant challenges for maternal and neonatal health, and yet its impact on neonatal outcomes remains poorly understood. This systematic review aims to evaluate the neonatal risks associated with PAC. Methods: A systematic search of PubMed, Embase, Scopus, and [...] Read more.
Background/Objectives: Pregnancy-associated cancer (PAC) presents significant challenges for maternal and neonatal health, and yet its impact on neonatal outcomes remains poorly understood. This systematic review aims to evaluate the neonatal risks associated with PAC. Methods: A systematic search of PubMed, Embase, Scopus, and other databases was conducted up to 1 November 2024, identifying observational studies and randomized controlled trials assessing neonatal outcomes in pregnancies affected by PAC. Outcomes included preterm birth, low birthweight, macrosomia, small and large for gestational age, low Apgar score, congenital anomalies, and neonatal mortality. Results: Eleven high-quality studies encompassing over 46 million births, including 9953 PAC-affected pregnancies, were reviewed. PAC significantly increased the risks of preterm birth (adjusted ORs ranging from 1.48 to 6.34) and low birthweight (adjusted ORs up to 5.5). Other adverse outcomes included low Apgar scores and neonatal mortality, primarily linked to prematurity. Cancer type and treatment timing influenced these outcomes, with gynecological and breast cancers posing higher risks. Conclusions: Neonates of mothers with PAC face increased risks of adverse outcomes, underscoring the importance of tailored, multidisciplinary management. Further prospective studies are needed to clarify the impacts of specific cancer treatments during pregnancy. Full article
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