Therapeutic pelvic lymph node dissection in the second gestational trimester: A case report and literature review

Abstract

Background: Management of cervical cancer during pregnancy remains unclear and varies according to stage of disease and gestational age at diagnosis. Specifically, local advanced cervical cancer in the third trimester of pregnancy presents as the most challenging. Materials and Methods: We reviewed all articles recently published in the Pubmed database about the treatment of cervical cancer in second and third trimester of pregnancy to be able to obtain the best decision regarding our presented case. The case and its treatment is described in detail and discussed according to available literature. Results: Our case proves that even beyond 25 gestational weeks a laparotomy with removal of 62 pelvic lymph nodes can be safely executed. Conclusion: Lymphadenectomy may be safe and feasible even after the 25th gestational week, and may be taken into consideration before making any decision concerning maintenance of pregnancy and providing individually-tailored oncological surgical procedure and optimal obstetrical care.