Work

Clinicopathological characteristics and prognostic outcomes of pregnancy-associated colorectal cancer: A 24-year experience

Year: 2025

Type: article

Abstract: BACKGROUND Colorectal cancer (CRC) during pregnancy poses significant risks to both maternal and fetal health; however, this topic remains under researched globally. AIM To investigate the impacts of clinical features, pathology type, treatment strategies, and tumor stage on maternal and fetal outcomes in pregnant patients with pregnancy-associated CRC (pCRC). METHODS To address this research gap, we analyzed the clinical and pathological characteristics of pCRC by collecting and evaluating clinicopathological data from 43 patients treated at the National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, between 1999 and 2023 using descriptive statistical methods. RESULTS Treatment for pCRC was initiated with surgery and/or chemotherapy. Among 43 patients, 37 underwent surgery, including 21 radical resections (5 prenatal and 16 postpartum resections) and 16 palliative surgeries. Chemotherapy (with regimens such as CapeOx or FOLFOX4) was administered to 37 patients. Six advanced-stage patients received chemotherapy alone. The gestational outcomes among the patients varied. Specifically, 5 patients who were diagnosed in early pregnancy chose abortion. Additionally, in mid-pregnancy, 3 patients underwent abortion, 1 required induced labor, and 2 underwent cesarean delivery with healthy neonates. Among the 3 late-pregnancy diagnoses, 1 patient underwent induced abortion, 1 delivered via cesarean section with a healthy fetus, and 1 underwent stillbirth management. The 5-year survival rate was 59.8%, with a rate of 100% for stage I/II patients, 75% for stage III patients, and 21.1% for stage IV patients. CONCLUSION Patients with poorly differentiated tumors exhibited worse outcomes than those with moderately and highly differentiated tumors. Early-stage diagnosis and timely treatment significantly improved maternal survival and fetal outcomes in pregnant patients with CRC. Advanced tumor stages and delayed diagnosis were observed to be associated with poorer maternal prognoses and may require interventions that compromise fetal survival. Fetal outcomes depend on the pathological stage of the mother’s cancer, the gestational age at diagnosis, and treatment strategies.

Source: World Journal of Gastroenterology

DOI: 10.3748/wjg.v31.i17.106508

Authors: Li-Wen Fan, Chao Shang, Qi Lin, Yan-Tao Tian, Dong-Kui Xu

Institutions: Hebei University of Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Cancer Hospital of Chinese Academy of Medical Sciences

Language: English

Topic: Colorectal Cancer Surgical Treatments

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Funders: Betsi Cadwaladr University Health Board, Public Health Wales, Cancer Research UK