Published online Jul 15, 2016. doi: 10.4251/wjgo.v8.i7.550
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
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.
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.