Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jul 15, 2016; 8(7): 550-554
Published online Jul 15, 2016. doi: 10.4251/wjgo.v8.i7.550
Management of colorectal neoplasia during pregnancy and in the postpartum period
Erman Aytac, Gokhan Ozuner, Ozgen Isik, Emre Gorgun, Luca Stocchi
Erman Aytac, Gokhan Ozuner, Ozgen Isik, Emre Gorgun, Luca Stocchi, Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH 44195, United States
Author contributions: Aytac E and Isik O collected and analyzed the data; Aytac E and Ozuner G drafted the manuscript; Stocchi L provided analytical oversight; Ozuner G, Aytac E and Gorgun E designed and supervised the study; Aytac E, Ozuner G, Isik O, Gorgun E and Stocchi L revised the manuscript for important intellectual content; Aytac E and Ozuner G offered the technical or material support; Ozuner G and Gorgun E provided administrative support; all authors have read and approved the final version to be published.
Institutional review board statement: Approved by the institutional review board.
Informed consent statement: A waiver of consent was obtained from the Institutional Review Board.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The study team used the data only.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Gokhan Ozuner, MD, FACS, FASCRS, Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave. A30, Cleveland, OH 44195, United States. ozunerg@ccf.org
Telephone: +1-216-4446672 Fax: +1-216-4458627
Received: January 4, 2016
Peer-review started: January 4, 2016
First decision: February 1, 2016
Revised: March 9, 2016
Accepted: April 20, 2016
Article in press: April 22, 2016
Published online: July 15, 2016
Processing time: 186 Days and 8.7 Hours
Abstract

AIM: To report our experience on management of colorectal neoplasia during pregnancy and in the postpartum period.

METHODS: Patients who were diagnosed with colorectal cancer during pregnancy or in the postpartum period (< 6 mo), between 8/1997 and 4/2013, in our department were reviewed. Patient characteristics, operations, fetal health and follow-up during pregnancy, type of delivery and oncologic outcomes were analyzed.

RESULTS: Eight patients met our study criteria. Median age at the time of diagnosis of colorectal cancer was 31 years. Median follow-up after surgery was 36 mo. Median duration of symptoms before diagnosis was 16 wk. Three patients were diagnosed with colorectal cancer during pregnancy and underwent surgery prior to delivery. None of the patients received adjuvant treatment during pregnancy. Five patients were diagnosed with colorectal cancer within a median of 2.1 mo after delivery and underwent surgery. No adverse neonatal outcomes were noted. All deliveries were at term (2 cesarean sections) except for one preterm delivery following low anterior resection on the 34th week of pregnancy.

CONCLUSION: There has been a significant delay in the diagnosis of colorectal cancer which is probably due to overlap of symptoms and signs between these tumors and a normal pregnancy. Surgery for colorectal cancer during pregnancy can be performed safely without compromising maternal and fetal outcomes.

Keywords: Colorectal cancer; Pregnancy; Postpartum; Neoplasia

Core tip: This paper summarizes the experience of a tertiary referral colorectal center in the United States on the management of colorectal neoplasia during the pregnancy and postpartum period. Eight patients who were diagnosed with colorectal cancer during pregnancy or in the postpartum period between 8/1997 and 4/2013 were reviewed. No maternal and neonatal mortality occurred related to surgical treatment. While surgery for colorectal cancer during pregnancy can be performed safely and may not affect maternal and fetal outcomes adversely, there has been a significant delay in the diagnosis of colorectal cancer which is probably due to overlap of symptoms and signs between these tumors and a normal pregnancy.