A eficácia do tratamento de câncer de colo uterino na gravidez uma análise do desfecho materno e fetal.
DOI:
https://doi.org/10.36557/2674-8169.2026v8n3p1540-1550Palavras-chave:
gravidez, câncer de colo de útero, quimioterapia neoadjuvante, traquelectomia radicalResumo
O diagnóstico do câncer de colo uterino durante a gravidez representa um desafio, pois seus sintomas são inespecíficos e facilmente confundidos com patologias mais frequentes, como aborto espontâneo. Embora os resultados oncológicos e obstétricos sejam promissores, ainda não existe um tratamento padrão, e a decisão sobre a continuidade da gravidez deve ser cuidadosamente discutida com a paciente e sua família, considerando a lacuna existente na medicina em relação aos riscos tanto para a mãe quanto para o feto. A quimioterapia neoadjuvante (NACT), utilizando principalmente quimioterápicos à base de platina, e a traquelectomia radical, mostraram ser eficazes nesse cenário. O objetivo desse estudo é analisar a eficácia das opções terapêuticas no tratamento do câncer de colo de útero em mulheres grávidas, considerando o desfecho materno e as repercussões fetais.
Foi utilizado como base de estudos o PubMed e a Biblioteca Virtual em Saúde (BVS) com os descritores de busca “uterine cervical neoplasms”, “pregnancy” e “treatment”. Foram utilizados como critérios de inclusão relatos de casos, estudos observacionais e ensaios clínicos controlados, publicados entre 2016 a 2024. Admitido como critério de exclusão fuga ao tema e artigos duplicados. Ao final foram selecionados 24 artigos, 16 deles analisaram o tratamento com quimioterapia neoadjuvante e 8 estudos analisaram o tratamento com traquelectomia radical. Em conclusão, ambos demonstraram desfechos maternos e fetais satisfatórios.
Downloads
Referências
Nagasawa S, Kasahara M, Aoki Y, Kusunoki S, Sugimori Y, Matsuoka S, Ogura K, Ogishima D. Successful pregnancy with stage IB2 uterine cervical cancer: A case report. Cancer Rep (Hoboken). 2022 Jul;5(7):e1542.
Bernardini F, Ferrandina G, Ricci C, Fagotti A, Fanfani F, Cavaliere AF, Gui B, Scambia G, De Vincenzo R. Neoadjuvant Chemotherapy in Pregnant Patients with Cervical Cancer: A Monocentric Retrospective Study. Curr Oncol. 2022 Aug 14;29(8):5702-14.
He Z, Xie C, Qi X, Hu Z, He Y. The effect of preserving pregnancy in cervical cancer diagnosed during pregnancy: a retrospective study. BMC Womens Health. 2022 Jul 25;22(1):314-22.
Li X, Zhang Y, Wu H, Li S, Ge S, Gao J. A case of neoadjuvant chemotherapy in pregnancy with cervical cancer (IB3). Cancer Treat Res Commun. 2024;38:100749-52.
Huang H, Quan Y, Qi X, Liu P. Neoadjuvant chemotherapy with paclitaxel plus cisplatin before radical surgery for locally advanced cervical cancer during pregnancy. Medicine. 2021 Aug 13;100(32):e26845.
Sánchez‐Cuerda C, Cuadra M, Gámir S, Lobo P, Elices M, Cabrera Y. Cervical adenocarcinoma in situ during pregnancy and subsequent fertility‐sparing therapy challenge. International journal of gynaecology and obstetrics. 2021 Oct 23;158(1):21–6.
Freudenreich R, Weiss M, Engler T, Neis F, Henes M. Characterization and clinical management of abnormal cytology findings in pregnant women: a retrospective analysis. Arch Gynecol Obstet. 2022 Aug 17;306(6):2017-26.
Enomoto S, Yoshihara K, Kondo E, Iwata A, Tanaka M, Tabata T, et al. Trends in pregnancy-associated cervical cancer in Japan between 2012 and 2017: a multicenter survey. Cancers (Basel). 2022 Jun 23;14(13):3056-69.
Fox CR, Burdeaux S, Downing KT. A 33-Year-Old Woman in the Third Trimester of Pregnancy Diagnosed with Advanced-Staged Squamous Cell Cervical Carcinoma by Magnetic Resonance Imaging and Biopsy. Am J Case Rep. 2021 Oct 13;22:e933639.
Akasaka M, Yoshida K, Maezawa T, Kondo E, Ikeda T, Iwamoto T. [Observation of Child Development in a Uterine Cervical Cancer Patient Who Received Chemotherapy during Pregnancy]. Gan To Kagaku Ryoho. 2021 Aug;48(8):1069-71.
Gómez Rodrigo S, Calderon J, Dionisi JN, Santi A, Mariconde JM, Rosato OD, et al. Cervical cancer in pregnancy at various gestational ages. International Journal of Gynecologic Cancer. 2021 Apr 30;31(5):784–8.
Lopez A, Rodriguez J, Estrada E, Aragona A, Chavez C, Amaro K, et al. Neoadjuvant chemotherapy in pregnant patients with cervical cancer: a Latin-American multicenter study. Int J Gynecol Cancer. 2021 03;31(3):468-74.
Perrotta M, Noll F, Cortez JPS, Bolaño L, Saadi JM, Odetto D. Simple trachelectomy with laparoscopic pelvic lymphadenectomy in a pregnant woman with a FIGO stage IA2 cervical cancer. Int J Gynecol Cancer. 2020 Oct;30(10):1652-53.
Levy L, Meuwly JY, Sarivalasis A, Achtari C, Mathevet P, Herrera FG. Survival of the fetus: cervical cancer and pregnancy, a challenging combination. The Lancet. 2020 Sep;396(10252):725-30.
Rabaiotti E, Girardelli S, Valsecchi L, Bergamini A, Petrone M, Mangili G, et al. Carboplatin Use in Pregnancy for Stage IB3 Cervical Cancer: Case Report and Review of the Literature. Journal of Adolescent and Young Adult Oncology. 2020 Jun 1;9(3):445–8.
Guo Y, Zhang D, Li Y, Wang Y. A case of successful maintained pregnancy after neoadjuvant chemotherapy plus radical surgery for stage IB3 cervical cancer diagnosed at 13 weeks. BMC Pregnancy Childbirth. 2020 Apr 7;20(1):202-6.
Oliveira AF, Souza LRMF, Paschoini MC, Murta EFC, Nomelini RS. Chemotherapy for cervical cancer in pregnancy. J Obstet Gynaecol. 2019 Apr;39(3):425-6.
Umemoto M, Ishioka S, Mizugaki Y, Fujibe Y, Mariya T, Kawamata A, et al. Obstetrical prognosis of patients who underwent vaginal radical trachelectomy during pregnancy. J Obstet Gynaecol Res. 2019 Jun;45(6):1167-72.
Kayahashi K, Mizumoto Y, Myojo S, Mitani Y, Tajima A, Fujiwara H. A successful case of neoadjuvant chemotherapy and radical hysterectomy during pregnancy for advanced uterine cervical cancer accompanied by neonatal erythroderma. J Obstet Gynaecol Res. 2018 Oct;44(10):2003-7.
De Vincenzo R, Tortorella L, Ricci C, Cavaliere AF, Zannoni GF, Cefalo MG, Scambia G, Fagotti A. Locally advanced cervical cancer complicating pregnancy: A case of competing risks from the Catholic University of the Sacred Heart in Rome. Gynecol Oncol. 2018 Sep;150(3):398-405.
Yoshihara K, Ishiguro T, Chihara M, Shima E, Adachi S, Isobe M, Haino K, Yamaguchi M, Sekine M, Kashima K, Takakuwa K, Nishikawa N, Enomoto T. The Safety and Effectiveness of Abdominal Radical Trachelectomy for Early-Stage Cervical Cancer During Pregnancy. Int J Gynecol Cancer. 2018 May;28(4):782-7.
Muallem MZ, Henrich W, Braun T, Sehouli J, Kretzschmar L. Therapeutic Pelvic Lymph Node Dissection in the Second Gestational Trimester: A Case Report and Literature Review. Anticancer Res. 2017 May;37(5):2487-90.
Capilna ME, Szabo B, Rusu SC, Becsi J, Szasz FC, Morariu M, Moldovan B, Pascanu IM. Abdominal radical trachelectomy (ART) performed during pregnancy: a case report. Eur J Gynaecol Oncol. 2017;38(1):129-31.
Ricci C, Scambia G, De Vincenzo R. Locally Advanced Cervical Cancer in Pregnancy: Overcoming the Challenge. A Case Series and Review of the Literature. Int J Gynecol Cancer. 2016 Oct;26(8):1490-6.
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2026 Camila Trotta Lourenço de Lemos, Marcela Gaiotti Marques, Julio César Silveira Brito Francisco , Ana Carolina Knaip Leite, Milena Silva e Sousa, Luísa Miranda Braga Lopes, Mariana Alfena Ostwald , Maria Victória da Costa Farfan
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Os autores são detentores dos direitos autorais mediante uma licença CCBY 4.0.
