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Melanoma and Gastrointestinal cancer during pregnancy George Pentheroudakis Assistant Professor of Oncology Medical School, University of Ioannina Greece
Physician Reaction   ,[object Object],[object Object],[object Object]
DISTRIBUTION  OF  CANCER  IN PREGNANT  WOMEN Cancer 25:380, 1970
ADVERSE   EFFECTS   OF   RADIATION  IN RELATION  TO  GESTATION  STAGES
RECOMMENDED  STAGING  IMAGING  TESTS   IN  PREGNANT  WOMEN  WITH CANCER ,[object Object],[object Object],[object Object]
EFFECTS  OF  CHEMOTHERAPY   BY GESTATIONAL  STAGE Maternal/fetal myelosup p ression, infections, hemorrhage. Perinatal period IUGR, low birth weight, premature birth 20- 3 0% 2 nd  and 3 rd  trimesters Abortion 20-30% Malformations 10-25% 1 st  trimester E   f   f   e   c   t S   t   a   g   e
Surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Melanoma and pregnancy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
M anagement ,[object Object],[object Object],[object Object]
SLNB? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Effect of pregnancy on melanoma   ,[object Object],[object Object],[object Object]
Survival of pregnant vs non-pregnant age- stage-matched patients with melanoma; California Cancer Registry 1991-1999
 
Conclusion:  Overall, the existing studies offer reassuring results concerning the risks of adverse birth outcome for women diagnosed with........before, during or shortly after pregnancy.
Most common GI malignancies in pregnancy ,[object Object],[object Object],[object Object],[object Object]
Peculiarities ,[object Object],[object Object],[object Object],[object Object]
Symptoms and presentation ,[object Object],[object Object],[object Object],[object Object]
Gastric cancer
Diagnostic work-up ,[object Object],[object Object],[object Object],[object Object],[object Object]
Colorectal cancer during pregnancy
Management of localised disease during first 20-24 weeks ,[object Object],[object Object],[object Object],[object Object],[object Object]
Management of localised disease after first 24 weeks of gestation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Advanced disease ,[object Object],[object Object],[object Object],[object Object]
Emergency procedures and Abortion ,[object Object],[object Object],[object Object],[object Object]
Prognosis ,[object Object],[object Object]
INCIDENCE  OF  INVOLVEMENT  OF   PRODUCTS  OF   CONCEPTION  BY  TUMOUR  TYPE  (out  of  98  cases)   28   (28.5%) Melanoma N o  of  CASES  (%) TUMOUR  TYPE 14  (14%) Breast  cancer  10  (10%) Leukemias  13  (13%) Lung  cancer 9  (9%) GI  cancers  8  (8%) Sarcomas 7  (7%) Lymphomas  3  (3%) Head-neck  cancer 2  (2%) Ovarian  cancer 2  (2%)  CUP 1  (1%) Cervical  cancer  1  (1%) Adrenal cancer
[object Object],A  MELANOMA  CASE
RECOMMENDATIONS  FOR   THERAPEUTIC ABORTION   ,[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical  recommendations ,[object Object],Annals  of  Oncology  2011 G. Pentheroudakis, N. Pavlidis & M. Castiglione  ESMO  Guidelines  Working  Group

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EASO2011 PanArab 4 Pentheroudakis

  • 1. Melanoma and Gastrointestinal cancer during pregnancy George Pentheroudakis Assistant Professor of Oncology Medical School, University of Ioannina Greece
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  • 3. DISTRIBUTION OF CANCER IN PREGNANT WOMEN Cancer 25:380, 1970
  • 4. ADVERSE EFFECTS OF RADIATION IN RELATION TO GESTATION STAGES
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  • 6. EFFECTS OF CHEMOTHERAPY BY GESTATIONAL STAGE Maternal/fetal myelosup p ression, infections, hemorrhage. Perinatal period IUGR, low birth weight, premature birth 20- 3 0% 2 nd and 3 rd trimesters Abortion 20-30% Malformations 10-25% 1 st trimester E f f e c t S t a g e
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  • 13. Survival of pregnant vs non-pregnant age- stage-matched patients with melanoma; California Cancer Registry 1991-1999
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  • 15. Conclusion: Overall, the existing studies offer reassuring results concerning the risks of adverse birth outcome for women diagnosed with........before, during or shortly after pregnancy.
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  • 27. INCIDENCE OF INVOLVEMENT OF PRODUCTS OF CONCEPTION BY TUMOUR TYPE (out of 98 cases) 28 (28.5%) Melanoma N o of CASES (%) TUMOUR TYPE 14 (14%) Breast cancer 10 (10%) Leukemias 13 (13%) Lung cancer 9 (9%) GI cancers 8 (8%) Sarcomas 7 (7%) Lymphomas 3 (3%) Head-neck cancer 2 (2%) Ovarian cancer 2 (2%) CUP 1 (1%) Cervical cancer 1 (1%) Adrenal cancer
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