309 results on '"Van Calsteren K"'
Search Results
52. 1831P - Update of the registry of young women with cancer by the International Network of Cancer, Infertility and Pregnancy
- Author
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Maggen, C., Van Calsteren, K., Cardonick, E., Shmakov, R.G., Gziri, M., Garcia, A.C., Fruscio, R., Lok, C.A.R., Halaska, M., Boere, I.A., Zola, P., Ottevanger, P., de Groot, C.J.M., Scarfone, G., Fumagalli, M., Painter, R.C., de Haan, J., and Amant, F.
- Published
- 2019
- Full Text
- View/download PDF
53. 1830P - Child development at 6 years after maternal cancer diagnosis and treatment during pregnancy
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Vandenbroucke, T., Verheecke, M., van Gerwen, M., Van Calsteren, K., Halaska, M., Fumagalli, M., Fruscio, R., Veening, M., Lagae, L., Ottevanger, P., Voigt, J.-U., de Haan, J., Gziri, M., Gandhi, A., Maggen, C., Mertens, L., Naulaers, G., Claes, L., and Amant, F.
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- 2019
- Full Text
- View/download PDF
54. 1069PD - Obstetric and maternal outcome of 134 patients with Hodgkin lymphoma diagnosed during pregnancy: Results from the INCIP registry
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Amant, F., Maggen, C., Dierickx, D., Lugtenburg, E., Laenen, A., Cardonick, E., Shmakov, R.G., Bellido Casado, M., Garcia, A.C., Gziri, M., Halaska, M., Ottevanger, P., Van Calsteren, K., L’Hauglin, A., Polushkina, E., Van Dam, L., Vandenberghe, P., and Woei-A-Jin, S.H.
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- 2019
- Full Text
- View/download PDF
55. Pediatric Outcome after Maternal Cancer Diagnosed during Pregnancy
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Amant, F., Vandenbroucke, T., Verheecke, M., Fumagalli, M., Halaska, M. J., Boere, I., Han, S., Gziri, M. M., Peccatori, F., Rob, L., Lok, C., Witteveen, P., Voigt, J-U, Naulaers, G., Vallaeys, L., Van den Heuvel, F., Lagae, L., Mertens, L., Claes, L., Van Calsteren, K., Amant, F., Vandenbroucke, T., Verheecke, M., Fumagalli, M., Halaska, M. J., Boere, I., Han, S., Gziri, M. M., Peccatori, F., Rob, L., Lok, C., Witteveen, P., Voigt, J-U, Naulaers, G., Vallaeys, L., Van den Heuvel, F., Lagae, L., Mertens, L., Claes, L., and Van Calsteren, K.
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- 2015
56. Pediatric Outcome after Maternal Cancer Diagnosed during Pregnancy
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Divisie Beeld & Oncologie, Cancer, MS MOD, Amant, F., Vandenbroucke, T., Verheecke, M., Fumagalli, M., Halaska, M. J., Boere, I., Han, S., Gziri, M. M., Peccatori, F., Rob, L., Lok, C., Witteveen, P., Voigt, J-U, Naulaers, G., Vallaeys, L., Van den Heuvel, F., Lagae, L., Mertens, L., Claes, L., Van Calsteren, K., Divisie Beeld & Oncologie, Cancer, MS MOD, Amant, F., Vandenbroucke, T., Verheecke, M., Fumagalli, M., Halaska, M. J., Boere, I., Han, S., Gziri, M. M., Peccatori, F., Rob, L., Lok, C., Witteveen, P., Voigt, J-U, Naulaers, G., Vallaeys, L., Van den Heuvel, F., Lagae, L., Mertens, L., Claes, L., and Van Calsteren, K.
- Published
- 2015
57. Chemotherapy during pregnancy: pharmacokinetics and impact on foetal neurological development
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van Calsteren, K., Amant, F., and Academic Medical Center
- Abstract
Based on an estimated incidence of cancer during pregnancy of 1 per 1000-1500 pregnancies, annualy 3000-5000 new patients can be expected in Europe. The treatment of cancer in pregnant women is a challenge since both the maternal and the foetal well-being need to be considered. This study was initiated to gain better insights into the problems associated with cancer and chemotherapy during pregnancy. A multicentric registration study was set up to evaluate the currently applied treatment modalities for cancer during pregnancy, and the consequences of their use for the pregnancy. Secondly, a preclinical and clinical pharmacological study addressing pharmacokinetics of chemotherapy in pregnant women and transplacental passage of chemotherapy was performed. Thirdly, we investigated the effects of prenatal exposure to chemotherapy on foetal neurological development. We observed an equal distribution of tumour types between pregnant and age matched nonpregnant women. Data on neonatal outcome suggest that exposure to chemotherapy in the 2nd or 3rd trimester of pregnancy does not worsen the outcome. This finding is explained by the fact that chemotherapy is not administered during the period of organogenesis and by the foetal protection by the placental barrier-function. Physiological changes of pregnancy resulted in a decreased plasma drug exposure of chemotherapeutic agents. Before major conclusions can be drawn with regard to the long term foetal outcome and the efficacy of chemotherapy during pregnancy, more patients and a longer follow up period is required. Therefore, this research project is continued and expanded nationally and internationally
- Published
- 2011
58. Spinal subdural haematoma after an epidural blood patch
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Devroe, S., primary, Van de Velde, M., additional, Demaerel, P., additional, and Van Calsteren, K., additional
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- 2015
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59. Breast cancer during pregnancy: a literature review
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Han, S. N., van Calsteren, K., Heyns, L., Mhallem Gziri, M., Amant, F., and Academic Medical Center
- Abstract
Breast cancer during pregnancy is relatively uncommon. However, the incidence is expected to increase as more women delay childbearing. A challenging situation emerges for all persons involved ‑ patient, family and medical care workers ‑ since two lives are at risk with contradicting priorities. Breast cancer treatment is possible during pregnancy. The treatment plan needs to adhere as closely as possible to standardised protocols for nonpregnant patients, with some considerations to minimize fetal exposure and risks. This concerns mainly limiting radiation exposure and timing of chemotherapy to start in the second trimester. The prognosis of pregnant women does not seem to differ from that of nonpregnant patients when matched for age and stage of the disease. This literature review concentrates on the diagnosis, treatment and outcome of patients diagnosed with breast cancer during pregnancy
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- 2010
60. Optimizing anticancer drug treatment in pregnant cancer patients: pharmacokinetic analysis of gestation-induced changes for doxorubicin, epirubicin, docetaxel and paclitaxel
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Sub Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, van Hasselt, J G C, van Calsteren, K, Heyns, L, Han, S, Mhallem Gziri, M, Schellens, J H M, Beijnen, J H, Huitema, A D R, Amant, F, Sub Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, van Hasselt, J G C, van Calsteren, K, Heyns, L, Han, S, Mhallem Gziri, M, Schellens, J H M, Beijnen, J H, Huitema, A D R, and Amant, F
- Published
- 2014
61. Gynecologic cancers in pregnancy: guidelines of a second international consensus meeting
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Amant, F, Halaska, M, Fumagalli, M, Dahl Steffensen, K, Lok, C, Van Calsteren, K, Han, S, Mir, O, Fruscio, R, Uzan, C, Maxwell, C, Dekrem, J, Strauven, G, Mhallem Gziri, M, Kesic, V, Berveiller, P, van den Heuvel, F, Ottevanger, P, Vergote, I, Lishner, M, Morice, P, Nulman, I, Nulman, I., FRUSCIO, ROBERT, Amant, F, Halaska, M, Fumagalli, M, Dahl Steffensen, K, Lok, C, Van Calsteren, K, Han, S, Mir, O, Fruscio, R, Uzan, C, Maxwell, C, Dekrem, J, Strauven, G, Mhallem Gziri, M, Kesic, V, Berveiller, P, van den Heuvel, F, Ottevanger, P, Vergote, I, Lishner, M, Morice, P, Nulman, I, Nulman, I., and FRUSCIO, ROBERT
- Abstract
This study aimed to provide timely and effective guidance for pregnant women and health care providers to optimize maternal treatment and fetal protection and to promote effective management of the mother, fetus, and neonate when administering potentially teratogenic medications. New insights and more experience were gained since the first consensus meeting 5 years ago.
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- 2014
62. Primary brain tumours, meningiomas and brain metastases in pregnancy: report on 27 cases and review of literature
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Verheecke, M, Halaska, M, Lok, C, Ottevanger, P, Fruscio, R, Dahl Steffensen, K, Kolawa, W, Gziri, M, Han, S, Van Calsteren, K, Van den Heuvel, F, De Vleeschouwer, S, Clement, P, Menten, J, Amant, F, Amant, F., FRUSCIO, ROBERT, Verheecke, M, Halaska, M, Lok, C, Ottevanger, P, Fruscio, R, Dahl Steffensen, K, Kolawa, W, Gziri, M, Han, S, Van Calsteren, K, Van den Heuvel, F, De Vleeschouwer, S, Clement, P, Menten, J, Amant, F, Amant, F., and FRUSCIO, ROBERT
- Abstract
The concurrence of intracranial tumours with pregnancy is rare. The purpose of this study was to describe all reported patients registered in the international Cancer in Pregnancy registration study (CIP study; http://www.cancerinpregnancy.org), and to review the literature in order to obtain better insight into outcome and possibilities of treatment in pregnancy.
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- 2014
63. Pushing the boundaries. Concurrent Hodgkin lymphoma and breast cancer treatment with preservation of pregnancy: A case report
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LeJeune Charlotte, Dierickx Daan, Wildiers Hans, Lannoo Lore, Van Calsteren Kristel, Vandecaveye Vincent, Menten Björn, Vermeesch Joris, and Amant Frédéric
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Pregnancy ,Breast cancer ,Hodgkin lymphoma ,Case report ,Gynecology and obstetrics ,RG1-991 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Breast cancer and hematological cancers are the most commonly diagnosed malignancies during pregnancy. This case report is the first to describe the ultimate challenge to preserve a pregnancy while the expectant mother is diagnosed and treated simultaneously for two concurrent primary malignancies, a stage IIA Hodgkin lymphoma and pT2N0(Sn) breast cancer. Clinical case: A 36-year-old pregnant primigravida underwent a routine non-invasive prenatal test at 14 weeks and 4 days of gestation. Genome-wide sequencing was used and revealed an aberrant DNA/chromosome copy number profile among which a strong 2p-gain, possibly related to a maternal malignancy. Physical examination showed an enlarged cervical lymph node and ultrasound guided biopsy confirmed the diagnosis of a nodular sclerosing classical Hodgkin lymphoma subsequently staged as an early stage, unfavorable (IIA) Hodgkin lymphoma. Whole body magnetic resonance imaging for further staging also indicated a suspicious nodule in the right breast. Further investigation resulted in the concurrent diagnosis of a pT2N0(Sn) invasive ductal adenocarcinoma. Patient underwent a mastectomy with sentinel lymph node biopsy at 15 weeks and 5 days of gestation, followed by 4-weekly chemotherapy administration, consisting of doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD). Pregnancy went further relatively uncomplicated and fetal assessment was reassuring during pregnancy. Due to fever of unknown origin and preterm labor, a cesarean section was performed on a gestational age of 35 weeks and 4 days. Oncological treatment was completed after delivery with involved-field radiation therapy for the Hodgkin lymphoma. Completion of systemic treatment for breast cancer consisted of docetaxel/cyclophosphamide chemotherapy, and anti-hormonal treatment in the form of ovarian function suppression and letrozole. Conclusion: Here we show for the first time that two concurrent primary malignancies can be treated successfully during pregnancy with respect to maternal and fetal chances. Motivated modifications of breast cancer treatment (mastectomy instead of lumpectomy, AVBD instead of epirubicin-cyclophosphamide chemotherapy), allowed treatment of both cancers during pregnancy. Final treatment was administered after delivery.
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- 2022
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64. Long-Term Neuropsychological and Cardiac Follow-Up of Children and Adults Who Were Antenatal Exposed to Radiotherapy
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Amant, F., primary, Vandenbroucke, T., additional, Verheecke, M., additional, Gziri, M.M., additional, Han, S.N., additional, van den Heuvel, F., additional, Lagae, L., additional, Willemsen, M.A., additional, Kapusta, L., additional, Ottevanger, P.B., additional, Mertens, L., additional, Claes, L., additional, and van Calsteren, K., additional
- Published
- 2014
- Full Text
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65. Cancer During Pregnancy: a Case-Control Analysis of Mental Development and Cardiac Functioning of 38 Children Prenatally Exposed to Chemotherapy
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Amant, F., primary, Vandenbroucke, T., additional, Verheecke, M., additional, Ottevanger, P.B., additional, Fumagalli, M., additional, Mertens, L., additional, Han, S.N., additional, van Calsteren, K., additional, and Claes, L., additional
- Published
- 2014
- Full Text
- View/download PDF
66. Unplanned Pregnancy During Cancer Treatment - on Behalf of the International Network of Cancer, Infertility and Pregnancy (Incip)
- Author
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van Peer, S., primary, Han, S.N., additional, Steffensen, K.D., additional, Halaska, M.J., additional, Gziri, M.M., additional, van Calsteren, K., additional, and Amant, F., additional
- Published
- 2014
- Full Text
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67. Estradiol and Weight Are Covariates of Paracetamol Clearance in Young Women
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Beleyn, B., primary, Vermeersch, S., additional, Kulo, A., additional, Smits, A., additional, Verbesselt, R., additional, de Hoon, J.N., additional, Van Calsteren, K., additional, and Allegaert, K., additional
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- 2014
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68. Cancer in pregnancy: a survey of current clinical practice
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Han, S, Kesic, V, Van Calsteren, K, Petkovic, S, Amant, F, Fruscio, R, FRUSCIO, ROBERT, Han, S, Kesic, V, Van Calsteren, K, Petkovic, S, Amant, F, Fruscio, R, and FRUSCIO, ROBERT
- Abstract
To evaluate physicians' attitudes and knowledge regarding the treatment possibilities for patients with cancer in pregnancy.
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- 2013
69. Hematologic Malignancies in Pregnancy
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Vandenbriele, C., Vassou, A., Pentheroudakis, G., Van Calsteren, K., Amant, F., Vandenbriele, C., Vassou, A., Pentheroudakis, G., Van Calsteren, K., and Amant, F.
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- 2011
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70. Abstract P6-07-05: Prognosis of 368 women with primary breast cancer during pregnancy: results from an international collaborative trial
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Amant, F, primary, von Minckwitz, G, additional, Han, SN, additional, Bontenbal, M, additional, Ring, A, additional, Giermek, J, additional, Fehm, T, additional, Wildiers, H, additional, Linn, SC, additional, Schlehe, B, additional, Neven, P, additional, Westenend, PJ, additional, Müller, V, additional, Van Calsteren, K, additional, Rack, B, additional, Nekljudova, V, additional, Harbeck, N, additional, Lenhard, M, additional, Witteveen, PO, additional, Kaufmann, M, additional, Van Calster, B, additional, and Loibl, S, additional
- Published
- 2012
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71. Does pregnancy affects pharmacokinetics of intravenous ketorolac?
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Allegaert, K., primary, Kulo, A., additional, van Calsteren, K., additional, Smits, A., additional, Verbesselt, R., additional, and Van de Velde, M., additional
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- 2012
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72. Cognitive and Cardiac Outcome After Prenatal Exposure to Chemotherapy in Children 18 Months or Older
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Amant, F., primary, Van Calsteren, K., additional, Halaska, M., additional, Mhallem, M., additional, Lagae, L., additional, Willemsen, M., additional, Kapusta, L., additional, Van Calster, B., additional, Mertens, L., additional, and Ottevanger, P., additional
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- 2011
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73. Transplacental transfer of anthracyclines, vinblastine, and 4-hydroxy-cyclophosphamide in a baboon model
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Van Calsteren, K., primary, Verbesselt, R., additional, Beijnen, J., additional, Devlieger, R., additional, De Catte, L., additional, Chai, D.C., additional, Van Bree, R., additional, Heyns, L., additional, de Hoon, J., additional, and Amant, F., additional
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- 2010
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74. Neoadjuvant chemotherapy followed by radical hysterectomy for invasive cervical cancer diagnosed during pregnancy: report of a case and review of the literature
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CALUWAERTS, S., primary, VAN CALSTEREN, K., additional, MERTENS, L., additional, LAGAE, L., additional, MOERMAN, P., additional, HANSSENS, M., additional, WUYTS, K., additional, VERGOTE, I., additional, and AMANT, F., additional
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- 2006
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75. Role of adnexectomy in the surgical treatment of cervical adenocarcinoma
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Van Calsteren, K., primary, Amant, F., additional, and Vergote, I., additional
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- 2005
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76. LBA49_PR - Long-Term Neuropsychological and Cardiac Follow-Up of Children and Adults Who Were Antenatal Exposed to Radiotherapy
- Author
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Amant, F., Vandenbroucke, T., Verheecke, M., Gziri, M.M., Han, S.N., van den Heuvel, F., Lagae, L., Willemsen, M.A., Kapusta, L., Ottevanger, P.B., Mertens, L., Claes, L., and van Calsteren, K.
- Published
- 2014
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77. 1527P_PR - Unplanned Pregnancy During Cancer Treatment - on Behalf of the International Network of Cancer, Infertility and Pregnancy (Incip)
- Author
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van Peer, S., Han, S.N., Steffensen, K.D., Halaska, M.J., Gziri, M.M., van Calsteren, K., and Amant, F.
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- 2014
- Full Text
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78. 267PD_PR - Cancer During Pregnancy: a Case-Control Analysis of Mental Development and Cardiac Functioning of 38 Children Prenatally Exposed to Chemotherapy
- Author
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Amant, F., Vandenbroucke, T., Verheecke, M., Ottevanger, P.B., Fumagalli, M., Mertens, L., Han, S.N., van Calsteren, K., and Claes, L.
- Published
- 2014
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79. Weight, pregnancy and oral contraceptives affect intravenous paracetamol clearance in young women.
- Author
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KULO, A., VAN CALSTEREN, K., VAN DE VELDE, M., MULABEGOVIC, N., VERBESSELT, R., DE HOON, J. N., VERHAEGHE, J., and ALLEGAERT, K.
- Abstract
OBJECTIVES: Because of the extensive variability in paracetamol clearance in young women, published data were pooled with newly collected observations in search of covariates of paracetamol pharmacokinetics (PK) within this specific population. SUBJECTS AND METHODS: PK estimates and clinical characteristics [pregnant, weight, exposure to oral contraceptives (OC)] in young women following IV loading dose (2 g paracetamol) were pooled, using a non-compartmental linear disposition model in individual time-concentration profiles. Data were reported by median and range. Rank correlation was used to link clearance (l/h) to weight, Mann Whitney U test to compare clearance (l/h.m-2) between subgroups (pregnant, OC exposure). Finally, a multiple regression model with clearance (l/h) in all women and all non-pregnant women was performed. RESULTS: Based on 73 paracetamol PK estimates, a 8-fold variability in clearance (range 7.1-62.2 l/h) was documented, in part explained by a correlation (r2=0.36) between clearance (l/h) and weight. Clearance (l/h and l/h.m-2) and distribution volume (l) at delivery (n=36) were higher compared to non-pregnant observations. In nonpregnant women, women on OC (n=20) had a higher paracetamol clearance (l/h.m-2) compared to women (n=17) not on OC (p = 0.023).Weight (p = 0.0043) and pregnancy (p = 0.02) were independent variables (r=0.56) of paracetamol clearance (l/h). In non-pregnant women, weight (p = 0.009) and OC exposure (p = 0.03) were independent variables (r=0.51). CONCLUSIONS:Weight, pregnancy and OC result in higher clearance of IV paracetamol in young women. Besides compound specific relevance, these findings also unveil covariates of drug metabolism in young women. [ABSTRACT FROM AUTHOR]
- Published
- 2014
80. Paracetamol and ketorolac pharmacokinetics and metabolism at delivery and during postpartum.
- Author
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ALLEGAERT, K., VAN CALSTEREN, K., HENDRICKX, S., KELCHTERMANS, J., SMITS, A., KULO, A., and VAN DE VELDE, M.
- Published
- 2012
81. Long-term cognitive and cardiac outcomes after prenatal exposure to chemotherapy in children aged 18 months or older: an observational study.
- Author
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Amant F, Van Calsteren K, Halaska MJ, Gziri MM, Hui W, Lagae L, Willemsen MA, Kapusta L, Van Calster B, Wouters H, Heyns L, Han SN, Tomek V, Mertens L, and Ottevanger PB
- Abstract
BACKGROUND: Chemotherapy for the treatment of maternal cancers during pregnancy has become more acceptable in the past decade; however, the effect of prenatal exposure to chemotherapy on cardiac and neurodevelopmental outcomes of the offspring is still uncertain. We aimed to record the general health, cardiac function, and neurodevelopmental outcomes of children who were prenatally exposed to chemotherapy. METHODS: We did an interim analysis of a multicentre observational cohort study assessing children who were prenatally exposed to maternal cancer staging and treatment, including chemotherapy. We assessed children at birth, at age 18 months, and at age 5-6, 8-9, 11-12, 14-15, or 18 years. We did clinical neurological examinations, tests of the general level of cognitive functioning (Bayley or intelligence quotient [IQ] test), electrocardiography and echocardiography, and administered a questionnaire on general health and development. From age 5 years, we also did audiometry, the Auditory Verbal Learning Test, and subtasks of the Children's Memory Scale, and the Test of Everyday Attention for Children, and we also completed the Child Behavior Checklist. This study is registered with ClinicalTrials.gov, number NCT00330447. FINDINGS: 236 cycles of chemotherapy were administered in 68 pregnancies. We assessed 70 children, born at a median gestational age of 35·7 weeks (range 28·3-41·0; IQR 3·3; 47 women at <37 weeks), with a median follow-up period of 22·3 months (range 16·8-211·6; IQR 54·9). Although neurocognitive outcomes were within normal ranges, cognitive development scores were lower for children who were born preterm than for those born at full term. When controlling for age, sex, and country, the score for IQ increased by an average 11·6 points (95% CI 6·0-17·1) for each additional month of gestation (p<0·0001). Our measurements of the children's behaviour, general health, hearing, and growth corresponded with those of the general population. Cardiac dimensions and functions were within normal ranges. We identified a severe neurodevelopmental delay in both members of one twin pregnancy. INTERPRETATION: Fetal exposure to chemotherapy was not associated with increased CNS, cardiac or auditory morbidity, or with impairments to general health and growth compared with the general population. However, subtle changes in cardiac and neurocognitive measurements emphasise the need for longer follow-up. Prematurity was common and was associated with impaired cognitive development. Therefore, iatrogenic preterm delivery should be avoided when possible. FUNDING: Research Foundation-Flanders; Research Fund-K U Leuven; Agency for Innovation by Science and Technology; Stichting tegen Kanker; Clinical Research Fund-University Hospitals Leuven; and Belgian Cancer Plan, Ministery of Health. [ABSTRACT FROM AUTHOR]
- Published
- 2012
82. Physiologic variations of serum tumor markers in gynecological malignancies during pregnancy: a systematic review
- Author
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Han Sileny N, Lotgerink Anouk, Gziri Mina, Van Calsteren Kristel, Hanssens Myriam, and Amant Frédéric
- Subjects
anti-Müllerian hormone ,CA 125 ,CA 15-3 ,cancer ,human epididymis secretory protein 4 (HE4) ,inhibin B ,lactate dehydrogenase ,pregnancy ,squamous-cell carcinoma antigen tumor markers ,Medicine - Abstract
Abstract Background Recent insights provide support for the treatment of cancer during pregnancy, a coincidence that poses both mother and fetus at risk. Our aim was to critically review studies on the physiologic variations during pregnancy, the most common tumor markers used in diagnosis and follow-up of gynecological cancers. Methods We conducted a systematic review of six tumor markers during normal pregnancy: carbohydrate antigen (CA) 15-3 (breast cancer); squamous cell carcinoma antigen (cervical cancer); and CA 125, anti-Müllerian hormone, inhibin B and lactate dehydrogenase (ovarian cancer). Results For CA 15-3, 3.3% to 20.0% of all measurements were above the cut-off (maximum 56 U/mL in the third trimester). Squamous cell carcinoma antigen values were above cut-off in 3.1% and 10.5% of the measurements (maximum 4.3 µg/L in the third trimester). Up to 35% of CA 125 levels were above cut-off: levels were highest in the first trimester, with a maximum value up to 550 U/mL. Inhibin B, anti-Müllerian hormone and lactate dehydrogenase levels were not elevated in maternal serum during normal pregnancy. Conclusion During normal pregnancy, tumor markers including CA 15.3, squamous cell carcinoma antigen and CA 125 can be elevated; inhibin B, anti-Müllerian hormone and lactate dehydrogenase levels remain below normal cut-off values. Knowledge of physiological variations during pregnancy can be clinically important when managing gynecological cancers in pregnant patients.
- Published
- 2012
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83. High-grade endometrial stromal sarcoma presenting in a 28-year-old woman during pregnancy: a case report
- Author
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Amant Frédéric, Van Calsteren Kristel, Debiec-Rychter Maria, Heyns Liesbeth, De Beeck Katya Op, Sagaert Xavier, Bollen Bart, and Vergote Ignace
- Subjects
Medicine - Abstract
Abstract Introduction To the best of our knowledge, soft tissue sarcomas have not prevously been reported as a complication during pregnancy. Case presentation A 28-year-old Caucasian woman was diagnosed with a transperitoneal sarcoma during pregnancy. Morphological, immunohistochemical, chromosomal and mutational analyses pointed towards a high-grade endometrial stromal sarcoma. Although surgery and chemotherapy are possible during pregnancy, we were unable to perform these in this case. Conclusion The potential to treat gynecological cancer during pregnancy should always be assessed individually.
- Published
- 2010
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84. TREATMENT OF BREAST CANCER DURING PREGNANCY: AN OBSERVATIONAL STUDY.
- Author
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Loibl, S., Han, S. N., von Minckwitz, G., Bontenbal, M., Ring, A., Giermek, J., Fehm, T., Van Calsteren, K., Linn, S. C., Schlehe, B., Gziri, M. M., Westenend, P. J., Müller, V., Heyns, L., Rack, B., Van Calster, B., Harbeck, N., Lenhard, M., Halaska, M. J., and Kaufmann, M.
- Subjects
BREAST cancer treatment ,CANCER in pregnancy ,BREAST cancer diagnosis ,RETROSPECTIVE studies ,DELIVERY (Obstetrics) ,CLINICAL trials ,FOLLOW-up studies (Medicine) - Abstract
Copyright of Meme Sagligi Dergisi / Journal of Breast Health is the property of Turkish Federation of Breast Diseases Associations and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2012
85. Cognitive and Behavioral Development of 9-Year-Old Children After Maternal Cancer During Pregnancy: A Prospective Multicenter Cohort Study
- Author
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Indra A. Van Assche, Evangeline A. Huis in 't Veld, Kristel Van Calsteren, Mathilde van Gerwen, Jeroen Blommaert, Elyce Cardonick, Michael J. Halaska, Robert Fruscio, Monica Fumagalli, Jurgen Lemiere, Elisabeth M. van Dijk-Lokkart, Camilla Fontana, Harm van Tinteren, Jessie De Ridder, Martine van Grotel, Marry M. van den Heuvel-Eibrink, Lieven Lagae, Frédéric Amant, Obstetrics and Gynaecology, CCA - Cancer Treatment and Quality of Life, CCA - Cancer biology and immunology, Amsterdam Reproduction & Development (AR&D), Van Assche, I, Huis In 'T Veld, E, Van Calsteren, K, Van Gerwen, M, Blommaert, J, Cardonick, E, Halaska, M, Fruscio, R, Fumagalli, M, Lemiere, J, Van Dijk-Lokkart, E, Fontana, C, Van Tinteren, H, De Ridder, J, Van Grotel, M, Van Den Heuvel-Eibrink, M, Lagae, L, and Amant, F
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Cancer Research ,Oncology ,Cancer in pregnancy - Abstract
Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.This multicenter cohort study reports on the long-term effects of prenatal exposure to maternal cancer and its treatment on cognitive and behavioral outcomes in 9-year-old children. In total, 151 children (mean age, 9.3 years; range, 7.8-10.6 years) were assessed using a neurocognitive test battery and parent-report behavioral questionnaires. During pregnancy, 109 children (72.2%) were exposed to chemotherapy (only or in combination with other treatment modalities), 18 (11.9%) to surgery only, 16 (10.6%) to radiotherapy, one to trastuzumab, and 16 (10.6%) were not exposed to oncologic treatment. Mean cognitive and behavioral outcomes were within normal ranges. Gestational age at birth showed a positive association with Full Scale Intelligence Quotient (FSIQ), with the average FSIQ score increasing by 1.6 points for each week increase in gestational age (95% CI, 0.7 to 2.5; P < .001). No difference in FSIQ was found between treatment types (F[4,140] = 0.45, P = .776). In children prenatally exposed to chemotherapy, no associations were found between FSIQ and chemotherapeutic agent, exposure level, or timing during pregnancy. These results indicate a reassuring follow-up during the critical maturational period of late childhood, when complex functions develop and rely on the integrity of early brain development. However, associations were observed with preterm birth, maternal death, and maternal education. ispartof: JOURNAL OF CLINICAL ONCOLOGY vol:41 issue:8 pages:1527-+ ispartof: location:United States status: published
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- 2023
86. Long-term neurodevelopmental outcome after prenatal exposure to maternal hematological malignancies with or without cytotoxic treatment
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Elyce Cardonick, Martine van Grotel, Elisabeth M. van Dijk-Lokkart, Evangeline Huis in ‘t Veld, Mathilde van Gerwen, Robert Fruscio, Camilla Fontana, Charlotte Maggen, Frédéric Amant, Marry M. van den Heuvel-Eibrink, Vit Drochytek, Giovanna Scarfone, Kristel Van Calsteren, Obstetrics, van Gerwen, M, Huis In 't Veld, E, van Grotel, M, van den Heuvel-Eibrink, M, Van Calsteren, K, Maggen, C, Drochytek, V, Scarfone, G, Fontana, C, Fruscio, R, Cardonick, E, van Dijk-Lokkart, E, Amant, F, Obstetrics and Gynaecology, CCA - Cancer Treatment and Quality of Life, Amsterdam Reproduction & Development (AR&D), Obstetrics and gynaecology, and CCA - Cancer Treatment and quality of life
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Male ,Pediatrics ,0302 clinical medicine ,hemic and lymphatic diseases ,Developmental and Educational Psychology ,Cognitive development ,Early childhood ,Child ,Child development ,05 social sciences ,Neuropsychology ,Myeloid leukemia ,Gestational age ,cancer in pregnancy ,intelligence ,follow-up studies ,3. Good health ,Neuropsychology and Physiological Psychology ,Prenatal Exposure Delayed Effects ,prenatal exposure delayed effect ,Female ,pregnancy ,Psychology ,Life Sciences & Biomedicine ,050104 developmental & child psychology ,medicine.medical_specialty ,Child, preschool ,Clinical Neurology ,follow-up studie ,Mothers ,Antineoplastic Agents ,hematologic malignancie ,Hematologic Neoplasms/complications ,03 medical and health sciences ,prenatal exposure delayed effects ,medicine ,Humans ,0501 psychology and cognitive sciences ,Pregnancy ,Science & Technology ,Infant, Newborn ,Infant ,Cancer ,hematologic malignancies ,medicine.disease ,Lymphoma ,Pediatrics, Perinatology and Child Health ,Neurosciences & Neurology ,030217 neurology & neurosurgery - Abstract
Data on the long-term neurodevelopmental outcomes of children exposed to hematological maternal cancer with or without treatment during pregnancy are lacking. A total of 57 children, of whom 33 males and 24 females, prenatally exposed to hematological malignancies and its treatment, were invited for neuropsychological and physical examinations at 18 months, 36 months, 6, 9, 12, 15 and 18 years of age. Oncological, obstetrical, neonatal and follow-up data of these children were collected. Parents were asked to complete questionnaires on their child's general health, school performances, social situation, behavioral development, executive functioning, and if their child receives supportive care. Non-Hodgkin lymphoma was diagnosed in 35.1%, Hodgkin lymphoma in 28.1%, acute myeloid leukemia in 15.8%, chronic myeloid leukemia in 12.3%, and acute lymphoblastic leukemia in 8.8%. Cognitive development at a median age of 10.7 years was within the normal range. In subgroup analyses of children in early childhood, the gestational age at birth was correlated with the cognitive outcome at a median age of 1.7 years. Scores for language development, intelligence, attention, memory and behavior, as well as clinical neurological and general pediatric examinations were within normal ranges. In subgroup analyses, the need for supportive care in the child was associated with the loss of the mother. Prenatal exposure to hematological maternal malignancies with or without treatment did not affect the neurodevelopment of the child in the long term. Yet, caution is indicated and surveillance of the emotional development of the child is needed, especially when the mother is deceased to cancer. ispartof: CHILD NEUROPSYCHOLOGY vol:27 issue:6 pages:822-833 ispartof: location:England status: published
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- 2021
87. Impact of chemotherapy during pregnancy on fetal growth
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Charlotte, Maggen, Vera E R A, Wolters, Kristel, Van Calsteren, Elyce, Cardonick, Annouschka, Laenen, Joosje H, Heimovaara, Mina, Mhallem Gziri, Robert, Fruscio, Johannes J, Duvekot, Rebecca C, Painter, Bianca, Masturzo, Roman G, Shmakov, Michael, Halaska, Paul, Berveiller, Magali, Verheecke, Jorine, de Haan, Sanne J, Gordijn, Frédéric, Amant, Graduate School, Obstetrics and Gynaecology, APH - Aging & Later Life, APH - Health Behaviors & Chronic Diseases, Amsterdam Reproduction & Development (AR&D), CCA - Cancer Treatment and Quality of Life, CCA - Cancer biology and immunology, Maggen, C, Wolters, V, Van Calsteren, K, Cardonick, E, Laenen, A, Heimovaara, J, Mhallem Gziri, M, Fruscio, R, Duvekot, J, Painter, R, Masturzo, B, Shmakov, R, Halaska, M, Berveiller, P, Verheecke, M, de Haan, J, Gordijn, S, Amant, F, Obstetrics & Gynecology, Obstetrics and gynaecology, and CCA - Cancer Treatment and quality of life
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OUTCOMES ,Science & Technology ,MATERNAL CANCER ,Obstetrics & Gynecology ,Obstetrics and Gynecology ,ONCOLOGY ,fetal growth restriction ,small for gestational age ,PRENATAL STRESS ,SDG 3 - Good Health and Well-being ,Pediatrics, Perinatology and Child Health ,BREAST-CANCER ,Chemotherapy ,cancer ,PLACENTA ,COHORT ,TRANSPLACENTAL TRANSFER ,pregnancy ,AGENTS ,Life Sciences & Biomedicine ,RESTRICTION - Abstract
BACKGROUND: Chemotherapy crosses the placenta, however, it remains unclear to what extent it affects fetal growth. The current literature suggests up to 21% of the offspring of women receiving chemotherapy are small for gestational age (SGA, birth weight
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- 2022
88. Association of Chemotherapy Timing in Pregnancy With Congenital Malformation
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van Gerwen, Mathilde, Maggen, Charlotte, Cardonick, Elyce, Verwaaijen, Emma J., van den Heuvel-eibrink, Marry, Shmakov, Roman G., Boere, Ingrid, Gziri, Mina M., Ottevanger, Petronella B., Lok, Christianne A. R., Halaska, Michael, Shao, Long Ting, Struys, Ilana, van Dijk-Lokkart, Elisabeth M., Van Calsteren, Kristel, Fruscio, Robert, Zola, Paolo, Scarfone, Giovanna, Amant, Frederic, on Cancer, Infertility and Pregnancy, International Network, Tummers, Philippe, Medical Oncology, UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - (SLuc) Service d'obstétrique, van Gerwen, M, Maggen, C, Cardonick, E, Verwaaijen, E, van den Heuvel-Eibrink, M, Shmakov, R, Boere, I, Gziri, M, Ottevanger, P, Lok, C, Halaska, M, Shao, L, Struys, I, van Dijk-Lokkart, E, Van Calsteren, K, Fruscio, R, Zola, P, Scarfone, G, Amant, F, Obstetrics and Gynaecology, CCA - Cancer Treatment and Quality of Life, ARD - Amsterdam Reproduction and Development, Obstetrics, Medical psychology, and Amsterdam Reproduction & Development (AR&D)
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Time Factors ,Abnormalities, Drug-Induced/etiology ,Miscarriage ,Cohort Studies ,Fetal Development ,Pregnancy ,Neoplasms ,Medicine and Health Sciences ,Odds Ratio ,First ,Original Investigation ,Abnormalities, Drug-Induced ,Adolescent ,Adult ,Antineoplastic Agents ,Female ,Gestational Age ,Humans ,Middle Aged ,Pregnancy Trimester, First ,Pregnant Women ,Young Adult ,Drug Administration Schedule ,education.field_of_study ,Obstetrics ,Fetal Development/drug effects ,Gestational age ,Obstetrics and Gynecology ,General Medicine ,Chemotherapy regimen ,Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] ,Online Only ,Oncology ,embryonic structures ,Gestation ,Pregnancy Trimester ,Abnormalities ,Life Sciences & Biomedicine ,Cohort study ,medicine.medical_specialty ,congenital malformation ,Population ,Medicine, General & Internal ,SDG 3 - Good Health and Well-being ,General & Internal Medicine ,medicine ,Chemotherapy ,education ,Science & Technology ,business.industry ,Research ,Antineoplastic Agents/adverse effects ,Odds ratio ,medicine.disease ,Neoplasms/drug therapy ,Drug-Induced ,business - Abstract
Key Points Question Is gestational age at initiation of chemotherapy during pregnancy associated with risk of congenital malformations? Findings In this cohort study including 755 pregnant women with cancer, the risk of major congenital malformations was elevated when first chemotherapy exposure was prior to 12 weeks of gestation, whereas the occurrence of major congenital malformations was similar to expected rates in the general population when chemotherapy was initiated after 12 weeks of gestation. Meaning The findings of this study could allow clinicians to better tailor chemotherapy during pregnancy and to inform patients on fetal risks of malformations., This cohort study assesses the association of gestational age at initiation of chemotherapy among pregnant women with cancer with congenital malformation rates among their offspring., Importance Chemotherapy during the first trimester of pregnancy should be avoided owing to the risk of congenital malformations. However, the precise gestational age at which chemotherapy can be initiated safely remains unclear. Objective To assess congenital malformation rates associated with gestational age at initiation of chemotherapy among pregnant women with cancer. Design, Setting, and Participants This multicenter cohort study evaluated all pregnant women who received chemotherapy between 1977 and 2019 registered in the International Network on Cancer, Infertility and Pregnancy (INCIP) database. Data were analyzed from February 15 to June 2, 2020. Exposures Cancer treatment with chemotherapy during pregnancy. Main Outcomes and Measures Analysis was focused on major and minor structural malformations in offspring, defined by EUROCAT, detected during pregnancy or at birth. Results A total of 755 women in the INCIP database who underwent cancer treatment with chemotherapy during pregnancy were included in analysis. The median (range) age at cancer diagnosis was 33 (14-48) years. Among offspring, the major congenital malformation rate was 3.6% (95% CI, 2.4%-5.2%), and the minor congenital malformation rate was 1.9% (95% CI, 1.0%-3.1%). Chemotherapy exposure prior to 12 weeks gestational age was associated with a high rate of major congenital malformations, at 21.7% (95% CI, 7.5%-43.7%; odds ratio, 9.24 [95% CI, 3.13-27.30]). When chemotherapy was initiated after gestational age 12 weeks, the frequency of major congenital malformations was 3.0% (95% CI, 1.9%-4.6%), which was similar to the expected rates in the general population. Minor malformations were comparable when exposure occurred before or after gestational age 12 weeks (4.3% [95% CI, 0.1%-21.9%] vs 1.8% [95% CI, 1.0-3.0]; odds ratio, 3.13 [95% CI, 0.39-25.28]). Of 29 women who received chemotherapy prior to 12 weeks gestation, 17 (58.6%) were not aware of pregnancy, and 6 (20.7%) experienced a miscarriage (3 women [10.3%]) or decided to terminate their pregnancy (3 women [10.3%]). Conclusions and Relevance This cohort study found that chemotherapy was associated with an increased risk of major congenital malformations only in the first 12 weeks of pregnancy. The risk of congenital malformations when chemotherapy was administered during the first trimester and the high number of incidental pregnancies during cancer treatment in the INCIP registry underscore the importance of contraceptive advice and pregnancy testing at the start of chemotherapeutic treatment in young women with cancer.
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- 2021
89. Renal and Bladder Cancer During Pregnancy: A Review of 47 Cases and Literature-based Recommendations for Management
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Maggen, Charlotte, Linssen, Jasmijn, Mhallem Gziri, Mina, Zola, Paolo, Cardonick, Elyce, de Groot, Christianne J M, Garcia, Alvaro Cabrera, Fruscio, Robert, Drochytek, Vit, Van Calsteren, Kristel, Albersen, Maarten, Amant, Frédéric, International Network on Cancer, Infertility and Pregnancy (INCIP)., UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Service d'obstétrique, Obstetrics and gynaecology, Amsterdam Reproduction & Development (AR&D), Obstetrics, Obstetrics and Gynaecology, CCA - Cancer Treatment and Quality of Life, Maggen, C, Linssen, J, Gziri, M, Zola, P, Cardonick, E, de Groot, C, Garcia, A, Fruscio, R, Drochytek, V, Van Calsteren, K, Albersen, M, and Amant, F
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030232 urology & nephrology ,Literature based ,urologic and male genital diseases ,0302 clinical medicine ,TUMOR ,Pregnancy ,Registries ,Kidney Neoplasms/mortality ,Obstetrics ,WOMAN ,2ND TRIMESTER ,Gestational age ,Urology & Nephrology ,RADICAL NEPHRECTOMY ,Middle Aged ,CARCINOMA COMPLICATING PREGNANCY ,Kidney Neoplasms ,Renal cancer ,030220 oncology & carcinogenesis ,bladder cancer ,young adult ,Gestation ,Premature Birth ,Female ,pregnancy ,Life Sciences & Biomedicine ,Pregnancy Complications, Neoplastic ,Infertility ,Adult ,medicine.medical_specialty ,Urology ,MEDLINE ,Pain ,Pain/etiology ,03 medical and health sciences ,Young Adult ,medicine ,Humans ,Labor, Induced ,Hematuria ,Retrospective Studies ,Bladder cancer ,Science & Technology ,business.industry ,Pregnancy Complications, Neoplastic/mortality ,Infant, Newborn ,Cancer ,CELL CARCINOMA ,medicine.disease ,Hematuria/etiology ,Urinary Bladder Neoplasms ,Urinary Bladder Neoplasms/mortality ,business - Abstract
OBJECTIVE: To provide contemporary gestational age-specific recommendations for management, a retrospective series of patients with renal or bladder cancer during pregnancy is reported. METHODS: Obstetric and oncological data of pregnant patients with a diagnosis of renal or bladder cancer were selected from the worldwide registry of the International Network of Cancer, Infertility and Pregnancy. In addition, the literature was reviewed for recent case reports since last reviews in 2014 for renal cancer and 2004 for bladder cancer. RESULTS: International Network of Cancer, Infertility and Pregnancy registered 22 cases (14 renal cancer and 8 bladder cancer), diagnosed between 1999 and 2017, and the literature reported 15 cases with renal cancer and 10 cases with bladder cancer between 2004 and 2019. Most common symptoms for renal and bladder cancer were pain (28%) and hematuria (66%), respectively. In more than half of the patients, surgical treatment was performed during pregnancy. Preterm deliveries were mostly medically induced (12 of 17, 71%) and all patients with a planned delivery before 34 weeks had advanced cancer. For renal and bladder cancer respectively, 79% and 87% of patients obtained complete remission. Advanced cancer stages had worse prognosis; 3 of 7 patients with known follow-up deceased within 15 months after diagnosis. CONCLUSION: Gestational age at diagnosis determines further management of renal and bladder cancers during pregnancy. Advanced stages challenge decision-making. The maternal needs for immediate treatment, and the neonatal risks including the impact of a preterm delivery should be discussed in a multidisciplinary setting while respecting the patient's autonomy. ispartof: UROLOGY vol:151 pages:118-126 ispartof: location:United States status: published
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- 2021
90. Population Pharmacokinetics of Docetaxel, Paclitaxel, Doxorubicin and Epirubicin in Pregnant Women with Cancer: A Study from the International Network of Cancer, Infertility and Pregnancy (INCIP)
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Ingrid A. Boere, Robert Fruscio, Jos H. Beijnen, Petronella O. Witteveen, Carolien P. Schröder, Rebecca C. Painter, Alwin D. R. Huitema, Petronella B. Ottevanger, Frédéric Amant, Julie M Janssen, Vit Drochytek, Thomas P. C. Dorlo, Michael J. Halaska, Ruud L.M. Bekkers, Kristel Van Calsteren, Guided Treatment in Optimal Selected Cancer Patients (GUTS), Janssen, J, Van Calsteren, K, Dorlo, T, Halaska, M, Fruscio, R, Ottevanger, P, Schroder, C, Boere, I, Witteveen, P, Painter, R, Bekkers, R, Drochytek, V, Beijnen, J, Huitema, A, Amant, F, Obstetrics and Gynaecology, APH - Aging & Later Life, APH - Health Behaviors & Chronic Diseases, ARD - Amsterdam Reproduction and Development, CCA - Cancer biology and immunology, Medical Oncology, RS: GROW - R2 - Basic and Translational Cancer Biology, and Obstetrie & Gynaecologie
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Oncology ,medicine.medical_specialty ,Cancer in pregnancy, pharmacokinetik ,Cyclophosphamide ,Paclitaxel ,medicine.medical_treatment ,RITONAVIR ,Breast Neoplasms ,Docetaxel ,030226 pharmacology & pharmacy ,PARAMETERS ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Pharmacokinetics ,SDG 3 - Good Health and Well-being ,MISSING DATA ,Pregnancy ,Internal medicine ,Neoplasms ,Antineoplastic Combined Chemotherapy Protocols ,CYCLOPHOSPHAMIDE ,medicine ,Humans ,Pharmacology (medical) ,Doxorubicin ,Epirubicin ,Pharmacology ,Chemotherapy ,business.industry ,medicine.disease ,3. Good health ,Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] ,MODEL ,chemistry ,030220 oncology & carcinogenesis ,Infertility ,Female ,Taxoids ,Pregnant Women ,business ,medicine.drug - Abstract
BACKGROUND: Based on reassuring short-term foetal and maternal safety data, there is an increasing trend to administer chemotherapy during the second and third trimesters of pregnancy. The pharmacokinetics (PK) of drugs might change as a result of several physiological changes that occur during pregnancy, potentially affecting the efficacy and safety of chemotherapy. OBJECTIVE: With this analysis, we aimed to quantitatively describe the changes in the PK of docetaxel, paclitaxel, doxorubicin and epirubicin in pregnant women compared with non-pregnant women. METHODS: PK data from 9, 20, 22 and 16 pregnant cancer patients from the International Network of Cancer, Infertility and Pregnancy (INCIP) were available for docetaxel, paclitaxel, doxorubicin and epirubicin, respectively. These samples were combined with available PK data from non-pregnant patients. Empirical non-linear mixed-effects models were developed, evaluating fixed pregnancy effects and gestational age as covariates. RESULTS: Overall, 82, 189, 271, and 227 plasma samples were collected from pregnant patients treated with docetaxel, paclitaxel, doxorubicin and epirubicin, respectively. The plasma PK data were adequately described by the respective models for all cytotoxic drugs. Typical increases in central and peripheral volumes of distribution of pregnant women were identified for docetaxel, paclitaxel, doxorubicin and epirubicin. Additionally, docetaxel, doxorubicin and paclitaxel clearance were increased in pregnant patients, resulting in lower exposure in pregnant women compared with non-pregnant patients. CONCLUSION: Given the interpatient variability, the identified pregnancy-induced changes in PK do not directly warrant dose adjustments for the studied drugs. Nevertheless, these results underscore the need to investigate the efficacy of chemotherapy, when administered during pregnancy. ispartof: CLINICAL PHARMACOKINETICS vol:60 issue:6 pages:775-784 ispartof: location:Switzerland status: published
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- 2021
91. Child development at 6 years after maternal cancer diagnosis and treatment during pregnancy
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Fedro A. Peccatori, Anna Babkova, Monica Fumagalli, Amarendra Gandhi, Michael J. Halaska, Charlotte Maggen, Ingrid A. Boere, Sofia Passera, Christianne A. R. Lok, Giovanna Scarfone, Magali Verheecke, Laurence Claes, Vít Drochýtek, Mathilde van Gerwen, Vincent Rigo, Martine van Grotel, Jorine de Haan, Martina Delle Marchette, Marry M. van den Heuvel-Eibrink, Gunnar Naulaers, Robert Fruscio, Tineke Vandenbroucke, Maria Lucia Boffi, Lieven Lagae, Mina Mhallem Gziri, Fabio Mosca, Margreet A. Veening, Jens-Uwe Voigt, Jana Dekrem, Luc Mertens, Kristel Van Calsteren, Christianne J.M. de Groot, Frédéric Amant, Vera E. R. A. Wolters, Els Witteveen, Odoardo Picciolini, Camilla Fontana, Jeroen Blommaert, Petronella B. Ottevanger, Renata Nacinovich, Frédéric Goffin, Carolina P. Schröder, Obstetrics and Gynaecology, CCA - Cancer Treatment and Quality of Life, ARD - Amsterdam Reproduction and Development, Obstetrics, Vandenbroucke, T, Verheecke, M, van Gerwen, M, Van Calsteren, K, Halaska, M, Fumagalli, M, Fruscio, R, Gandhi, A, Veening, M, Lagae, L, Ottevanger, P, Voigt, J, de Haan, J, Gziri, M, Maggen, C, Mertens, L, Naulaers, G, Claes, L, Amant, F, Blommaert, J, Dekrem, J, Goffin, F, Rigo, V, Fontana, C, Mosca, F, Passera, S, Picciolini, O, Scarfone, G, Peccatori, F, Boffi, M, Delle Marchette, M, Nacinovich, R, Lok, C, Wolters, V, Boere, I, Witteveen, E, Schroder, C, de Groot, C, van Grotel, M, van den Heuvel-Eibrink, M, Babkova, A, Drochytek, V, Obstetrics and gynaecology, Pediatric surgery, CCA - Cancer Treatment and quality of life, Amsterdam Reproduction & Development (AR&D), Erasmus MC other, Medical Oncology, and Pathology
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0301 basic medicine ,Male ,Pediatrics ,Cancer Research ,Memory/drug effects ,Intelligence ,Pregnancy Complications, Neoplastic/drug therapy ,0302 clinical medicine ,Diastole ,Pregnancy ,Antineoplastic agents ,Medicine ,Childbirth ,Fertility preservation ,Prospective Studies ,Child ,Child development ,Original Research ,media_common ,Cervical cancer ,0303 health sciences ,Prenatal exposure delayed effect ,Intelligence quotient ,Obstetrics ,High risk ,Hematology ,Prenatal exposure delayed effects ,Chemotherapy regimen ,Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] ,3. Good health ,Antineoplastic agent ,Oncology ,030220 oncology & carcinogenesis ,Female ,Pregnancy Complications, Neoplastic ,Cohort study ,Adult ,medicine.medical_specialty ,Child, preschool ,media_common.quotation_subject ,Fertility ,Follow-up studies ,03 medical and health sciences ,Intelligence/drug effects ,Breast cancer ,SDG 3 - Good Health and Well-being ,Memory ,media_common.cataloged_instance ,Humans ,European union ,Child Development/drug effects ,030304 developmental biology ,Diastole/drug effects ,Follow-up studie ,business.industry ,Cancer ,Infant ,Antineoplastic Agents/adverse effects ,medicine.disease ,Clinical trial ,030104 developmental biology ,business - Abstract
Background Data on the long-term effects of prenatal exposure to maternal cancer and its treatment on child development are scarce. Methods In a multicenter cohort study, the neurologic and cardiac outcomes of 6-year-old children born to women diagnosed with cancer during pregnancy were compared with the outcome of children born after an uncomplicated pregnancy. Assessment included clinical evaluation, comprehensive neuropsychological testing, electrocardiography and echocardiography. Results In total, 132 study children and 132 controls were included. In the study group, 97 children (73.5%) were prenatally exposed to chemotherapy (alone or in combination with other treatments), 14 (10.6%) to radiotherapy (alone or in combination), 1 (0.8%) to trastuzumab, 12 (9.1%) to surgery alone and 16 (12.1%) to no treatment. Although within normal ranges, statistically significant differences were found in mean verbal IQ and visuospatial long-term memory, with lower scores in the study versus control group (98.1, 95% confidence interval [CI]: 94.5–101.8, versus 104.4, 95% CI: 100.4–108.4, P = 0.001, Q, Highlights • Cancer treatment including chemotherapy is possible during pregnancy. • Children are at risk for lower verbal IQ and visuospatial long-term memory scores. • Other cognitive functions and cardiac outcomes were normal at the age of 6 years. • We documented ototoxicity in three children exposed to cisplatin. • Follow-up until adulthood is recommended.
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- 2020
92. Data describing child development at 6 years after maternal cancer diagnosis and treatment during pregnancy
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J. de Haan, Michael J. Halaska, K. Van Calsteren, Petronella B. Ottevanger, Charlotte Maggen, Gunnar Naulaers, Robert Fruscio, Mina Mhallem Gziri, Monica Fumagalli, Frédéric Amant, M. Verheeckec, T. Vandenbrouckec, Jens-Uwe Voigt, Laurence Claes, Lieven Lagae, Margreet A. Veening, Amarendra Gandhi, Luc Mertens, M. van Gerwena, UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - (SLuc) Service d'obstétrique, van Gerwena, M, Vandenbrouckec, T, Verheeckec, M, Van Calsteren, K, Halaska, M, Fumagalli, M, Fruscio, R, Gandhi, A, Veening, M, Lagae, L, Ottevanger, P, Voigt, J, de Haan, J, Gziri, M, Maggen, C, Mertens, L, Naulaers, G, Claes, L, Amant, F, Obstetrics, and Obstetrics and gynaecology
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Pediatrics ,medicine.medical_specialty ,High-risk ,Subgroup analysis ,Follow-up studies ,lcsh:Computer applications to medicine. Medical informatics ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Antineoplastic agents ,Medicine ,lcsh:Science (General) ,Child development ,Data Article ,030304 developmental biology ,0303 health sciences ,Univariate analysis ,Multidisciplinary ,Follow-up studie ,business.industry ,Incidence (epidemiology) ,Cancer ,Infant ,medicine.disease ,Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] ,3. Good health ,Antineoplastic agent ,Prenatal Exposure Delayed Effects ,lcsh:R858-859.7 ,Neuropsychological testing ,General health ,business ,030217 neurology & neurosurgery ,lcsh:Q1-390 - Abstract
Contains fulltext : 226030.pdf (Publisher’s version ) (Open Access) This manuscript is an accompanying resource of the original research article entitled "Child development at 6 years after maternal cancer diagnosis and treatment during pregnancy" and present data that compare the outcome of 6-year-old-children born to women diagnosed with cancer during pregnancy (with or without treatment during pregnancy) (study group) with children born after an uncomplicated pregnancy (control group). Oncological, obstetrical and neonatal data were collected. Neurodevelopment was examined by clinical evaluation and neuropsychological testing (including intelligence, attention and memory tests) and by general health and behavior questionnaires. Cardiac evaluation included electro- and echocardiography. Univariate analyses of covariance were used to investigate between-group differences. A subgroup analysis was performed in chemotherapy-exposed children versus controls and anthracycline-exposed versus controls. Additionally, the incidence of behaviour problems was compared to matched controls for children whose mothers died and for those with surviving mothers.
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- 2020
93. Gastric cancer during pregnancy: A report on 13 cases and review of the literature with focus on chemotherapy during pregnancy
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Charlotte Maggen, Elyce Cardonick, Michael J. Halaska, Mathilde van Gerwen, Martin Koskas, Petronella B. Ottevanger, Robert Fruscio, Christianne A.R. Lok, Ingrid A. Boere, Kristel Van Calsteren, Frédéric Amant, Petronella O. Witteveen, Mina Mhallem Gziri, Maggen, C, Lok, C, Cardonick, E, Van Gerwen, M, Ottevanger, N, Boere, I, Koskas, M, Halaska, M, Fruscio, R, Mhallem, M, Witteveen, P, Van Calsteren, K, Amant, F, Obstetrics, Obstetrics and Gynaecology, CCA - Cancer Treatment and Quality of Life, Medical Oncology, UCL - SSS/IREC/SLUC - Pôle St.-Luc, and UCL - (SLuc) Service d'obstétrique
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medicine.medical_treatment ,chemotherapy ,Pregnancy Complications, Neoplastic/drug therapy ,0302 clinical medicine ,Pre-Eclampsia ,Antineoplastic Combined Chemotherapy Protocols ,Obstetrics and Gynaecology ,Original Research Article ,030212 general & internal medicine ,Maternal-Fetal Exchange ,obstetric outcome ,Fetal Growth Retardation/chemically induced ,Fetal Growth Retardation ,030219 obstetrics & reproductive medicine ,Obstetrics ,Obstetrics and Gynecology ,Gestational age ,General Medicine ,Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] ,3. Good health ,Oncology ,Prenatal Exposure Delayed Effects ,Premature Birth ,Female ,pregnancy ,Pregnancy Complications, Neoplastic ,Adult ,Infertility ,medicine.medical_specialty ,Pre-Eclampsia/chemically induced ,Antineoplastic Agents ,Preeclampsia ,03 medical and health sciences ,SDG 3 - Good Health and Well-being ,Stomach Neoplasms ,medicine ,Humans ,Brain abscess ,Pregnancy ,Fetus ,Chemotherapy ,pregnancy outcome ,business.industry ,gastric cancer ,Antineoplastic Combined Chemotherapy Protocols/adverse effects ,Infant, Newborn ,Cancer ,Antineoplastic Agents/adverse effects ,medicine.disease ,maternal outcome ,Stomach Neoplasms/drug therapy ,business ,Gastric cancer - Abstract
INTRODUCTION: Gastric cancer during pregnancy is extremely rare and data on optimal treatment and possible chemotherapeutic regimens are scarce. The aim of this study is to describe the obstetric and maternal outcome of women with gastric cancer during pregnancy and review the literature on antenatal chemotherapy for gastric cancer. MATERIAL AND METHODS: Treatment and outcome of patients registered in the International Network on Cancer, Infertility and Pregnancy database with gastric cancer diagnosed during pregnancy were analyzed. RESULTS: In total, 13 women with gastric cancer during pregnancy were registered between 2002 and 2018. Median gestational age at diagnosis was 22 weeks (range 6-30 weeks). Twelve women were diagnosed with advanced disease and died within 2 years after pregnancy, most within 6 months. In total, eight out of 10 live births ended in a preterm delivery because of preeclampsia, maternal deterioration, or therapy planning. Two out of six women who initiated chemotherapy during pregnancy delivered at term. Two neonates prenatally exposed to chemotherapy were growth restricted and one of them developed a systemic infection with brain abscess after preterm delivery for preeclampsia 2 weeks after chemotherapy. No malformations were reported. CONCLUSIONS: The prognosis of gastric cancer during pregnancy is poor, mainly due to advanced disease at diagnosis, emphasizing the need for early diagnosis. Antenatal chemotherapy can be considered to reach fetal maturity, taking possible complications such as growth restriction, preterm delivery, and hematopoietic suppression at birth into account. ispartof: ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA vol:99 issue:1 pages:79-88 ispartof: location:United States status: published
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- 2020
94. Oncological management and obstetric and neonatal outcomes for women diagnosed with cancer during pregnancy: a 20-year international cohort study of 1170 patients
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Petronella B. Ottevanger, Evgeniya Polushkina, Lorenzo Ceppi, Karina Dahl Steffensen, Roman G. Shmakov, Fedro A. Peccatori, Christianne J.M. de Groot, Frédéric Amant, Mina Mhallem Gziri, Magali Verheecke, Elyce Cardonick, Sileny Han, Lukas Rob, Paolo Zola, Michael J. Halaska, Kristel Van Calsteren, Ben Van Calster, Ingrid A. Boere, Robert Fruscio, Christianne A.R. Lok, Gennady T. Sukhikh, Jorine de Haan, de Haan, J, Verheecke, M, Van Calsteren, K, Van Calster, B, Shmakov, R, Mhallem Gziri, M, Halaska, M, Fruscio, R, Lok, C, Boere, I, Zola, P, Ottevanger, P, de Groot, C, Peccatori, F, Dahl Steffensen, K, Cardonick, E, Polushkina, E, Rob, L, Ceppi, L, Sukhikh, G, Han, S, Amant, F, CCA - Cancer Treatment and Quality of Life, Obstetrics and Gynaecology, ARD - Amsterdam Reproduction and Development, Medical Oncology, Obstetrics and gynaecology, CCA - Cancer Treatment and quality of life, and Amsterdam Reproduction & Development (AR&D)
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Male ,Fetal Membranes, Premature Rupture ,Time Factors ,Neonatal intensive care unit ,Fetal Membranes, Premature Rupture/chemically induced ,Patient Admission ,0302 clinical medicine ,Pregnancy ,Risk Factors ,Birth Weight ,Prospective Studies ,Registries ,Prospective cohort study ,030219 obstetrics & reproductive medicine ,Obstetrics ,Incidence ,Gestational age ,United States/epidemiology ,3. Good health ,Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] ,Europe ,Treatment Outcome ,Oncology ,Premature birth ,030220 oncology & carcinogenesis ,Infant, Small for Gestational Age ,Premature Birth ,Female ,Pregnancy Complications, Neoplastic ,Live Birth ,medicine.medical_specialty ,Pregnancy Complications, Neoplastic/diagnosis ,Antineoplastic Agents ,Gestational Age ,Europe/epidemiology ,03 medical and health sciences ,Breast cancer ,All institutes and research themes of the Radboud University Medical Center ,SDG 3 - Good Health and Well-being ,Intensive Care Units, Neonatal ,medicine ,Humans ,Retrospective Studies ,business.industry ,Infant, Newborn ,Retrospective cohort study ,Antineoplastic Agents/adverse effects ,medicine.disease ,United States ,Premature Birth/chemically induced ,Small for gestational age ,business - Abstract
BACKGROUND: Awareness is growing that cancer can be treated during pregnancy, but the effect of this change on maternal and neonatal outcomes is unknown. The International Network on Cancer, Infertility and Pregnancy (INCIP) registers the incidence and maternal, obstetric, oncological, and neonatal outcomes of cancer occurring during pregnancy. We aimed to describe the oncological management and obstetric and neonatal outcomes of patients registered in INCIP and treated in the past 20 years, and assess associations between cancer type or treatment modality and obstetric and neonatal outcomes. METHODS: This descriptive cohort study included pregnant patients with cancer registered from all 37 centres (from 16 countries) participating in the INCIP registry. Oncological, obstetric, and neonatal outcome data of consecutive patients diagnosed with primary invasive cancer during pregnancy between Jan 1, 1996, and Nov 1, 2016, were retrospectively and prospectively collected. We analysed changes over time in categorical patient characteristics, outcomes, and treatment methods with log-binomial regression. We used multiple logistic regression to analyse preterm, prelabour rupture of membranes (PPROM) or preterm contractions, small for gestational age, and admission to the neonatal intensive care unit (NICU). The INCIP registry study is registered with ClinicalTrials.gov, number NCT00330447, and is ongoing. FINDINGS: 1170 patients were included in the analysis and 779 (67%) received treatment during pregnancy. Breast cancer was the most common malignant disease (462 [39%]). Every 5 years, the likelihood of receiving treatment during pregnancy increased (relative risk [RR] 1·10, 95% CI 1·05-1·15), mainly related to an increase of chemotherapeutic treatment (1·31, 1·20-1·43). Overall, 955 (88%) of 1089 singleton pregnancies ended in a livebirth, of which 430 (48%) of 887 pregnancies ended preterm. Each 5 years, we observed more livebirths (RR 1·04, 95% CI 1·01-1·06) and fewer iatrogenic preterm deliveries (0·91, 0·84-0·98). Our data suggest a relationship between platinum-based chemotherapy and small for gestational age (odds ratio [OR] 3·12, 95% CI 1·45-6·70), and between taxane chemotherapy and NICU admission (OR 2·37, 95% CI 1·31-4·28). NICU admission seemed to depend on cancer type, with gastrointestinal cancers having highest risk (OR 7·13, 95% CI 2·86-17·7) and thyroid cancers having lowest risk (0·14, 0·02-0·90) when compared with breast cancer. Unexpectedly, the data suggested that abdominal or cervical surgery was associated with a reduced likelihood of NICU admission (OR 0·30, 95% CI 0·17-0·55). Other associations between treatment or cancer type and outcomes were less clear. INTERPRETATION: Over the years, the proportion of patients with cancer during pregnancy who received antenatal treatment increased, especially treatment with chemotherapy. Our data indicate that babies exposed to antenatal chemotherapy might be more likely to develop complications, specifically small for gestational age and NICU admission, than babies not exposed. We therefore recommend involving hospitals with obstetric high-care units in the management of these patients. FUNDING: Research Foundation-Flanders, European Research Council, Charles University, Ministry of Health of the Czech Republic. ispartof: The Lancet Oncology vol:19 issue:3 pages:337-346 ispartof: location:England status: published
- Published
- 2018
95. Maternal and obstetrical outcome in 35 cases of well‐differentiated thyroid carcinoma during pregnancy
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Christianne J.M. de Groot, Frédéric Amant, Philipp Klaritsch, Karina Dahl Steffensen, Paolo Zola, Elske T. Massolt, Jan Plzak, Kristel Van Calsteren, Jorine de Haan, Michael J. Halaska, Jan Bouček, Robert Fruscio, Internal Medicine, Boucek, J, de Haan, J, Halaska, M, Plzak, J, Van Calsteren, K, de Groot, C, Dahl, S, Fruscio, R, Massolt, E, Klaritsch, P, Zola, P, Amant, F, ARD - Amsterdam Reproduction and Development, CCA - Cancer Treatment and Quality of Life, Obstetrics and Gynaecology, Obstetrics and gynaecology, Amsterdam Reproduction & Development (AR&D), and CCA - Cancer Treatment and quality of life
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Databases, Factual ,Thyroid Gland ,Thyroid Gland/pathology ,Cohort Studies ,Pregnancy Complications, Neoplastic/pathology ,0302 clinical medicine ,Thyroidectomy/adverse effects ,Pregnancy ,Thyroid cancer ,Cancer ,Outcome ,Thyroid ,Treatment ,Otorhinolaryngology2734 Pathology and Forensic Medicine ,treatment ,Obstetrics ,Pregnancy Outcome ,Gestational age ,Thyroid Neoplasms/pathology ,3. Good health ,Survival Rate ,Treatment Outcome ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,outcome ,Thyroidectomy ,Female ,Pregnancy Complications, Neoplastic ,Cohort study ,Adult ,medicine.medical_specialty ,030209 endocrinology & metabolism ,Pregnancy Outcome/epidemiology ,Thyroid carcinoma ,03 medical and health sciences ,Journal Article ,medicine ,cancer ,Humans ,Thyroid Neoplasms ,Survival rate ,business.industry ,medicine.disease ,Otorhinolaryngology2734, Pathology and Forensic Medicine ,Otorhinolaryngology ,business ,Follow-Up Studies - Abstract
OBJECTIVES/HYPOTHESIS: Thyroid cancer, with 6% to 10% of cancer diagnoses, is one of the most common malignancies during pregnancy. Its treatment poses a risk for the pregnancy, as the thyroid gland plays a crucial role in the evolution of pregnancy. The aim of this study is to evaluate treatment of primary well-differentiated thyroid carcinoma during pregnancy and fetal and maternal outcomes.STUDY DESIGN: This is an international cohort study.METHODS: Primary thyroid cancer patients were identified from the database of the International Network on Cancer, Infertility, and Pregnancy registration study. Data on histopathological characteristics, diagnostic and therapeutic interventions, outcome (obstetrical, neonatal, and maternal) and maternal follow-up were analyzed.RESULTS: Thirty-five patients with well-differentiated thyroid carcinoma were eligible. All 35 patients underwent surgery, 29 (83%) of which during pregnancy. Procedures during pregnancy were mainly total thyroidectomies (n = 24). The median number of days between diagnosis and surgical treatment was different between the groups with surgery during and after pregnancy (27 vs. 139 days, P < .001). Both maternal and neonatal outcomes were uncomplicated, regardless of gestational age during surgery.CONCLUSIONS: Well-differentiated thyroid carcinoma diagnosed during pregnancy has a favorable outcome for both mother and child. Surgical management during pregnancy has no negative impact on the pregnancy regardless of the trimester at the time of surgery. However, the potential negative effects of thyroid surgery early in pregnancy demand management of these patients in an experienced multidisciplinary team to provide the best possible care for these patients and their unborn babies.LEVEL OF EVIDENCE: 4 Laryngoscope, 2017.
- Published
- 2017
96. Characteristics of patients with cervical cancer during pregnancy:a multicenter matched cohort study. An initiative from the International Network on Cancer, Infertility and Pregnancy
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Karina Dahl Steffensen, Sileny Han, Lukas Rob, Hana Stankusova, Astrid Mephon, Catherine Uzan, Frédéric Amant, Kristina Van Calsteren, Ben Van Calster, Michael J. Halaska, Roman Rouzier, Petronella O. Witteveen, Martina Delle Marchette, Robert Fruscio, Patrizia Vergani, Halaska, M, Uzan, C, Han, S, Fruscio, R, Dahl Steffensen, K, Van Calster, B, Stankusova, H, DELLE MARCHETTE, M, Mephon, A, Rouzier, R, Witteveen, P, Vergani, P, Van Calsteren, K, Rob, L, Amant, F, ARD - Amsterdam Reproduction and Development, CCA - Cancer Treatment and Quality of Life, and Obstetrics and Gynaecology
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Infertility ,Cervical cancer ,Chemotherapy ,medicine.medical_specialty ,Pregnancy ,business.industry ,Obstetrics ,cervical cancer ,medicine.medical_treatment ,Hazard ratio ,Obstetrics and Gynecology ,Cancer ,Gestational age ,medicine.disease ,Oncology ,Medicine ,pregnancy ,Stage (cooking) ,business - Abstract
BackgroundTreatment of cervical cancer during pregnancy is often complex and challenging. This study aimed to analyze current patterns of practice in the management of pregnant patients diagnosed with cervical cancer.MethodsThis was a matched cohort study comprising patients managed for cervical cancer during pregnancy from six European centers. Patient information was retrieved from the dataset of the International Network for Cancer, Infertility and Pregnancy from 1990 to 2012. Each center matched its patients with two non-pregnant controls for age (±5 years) and International Federation of Gynecology and Obstetrics (FIGO) 2009 stage. Information on age, histological type, grade, lymphovascular space invasion, stage, tumor size, method of diagnosis, site of recurrence, delivery, date of recurrence, and date of death was recorded. Progression-free survival was compared using multivariable Cox proportional hazards regression.ResultsA total of 132 pregnant patients and 256 controls were analyzed. The pregnant patients (median age 34 years, range 21–43) were diagnosed at a median gestational age of 18.4 weeks of pregnancy (range 7–39). Stage distribution during pregnancy was 14.4% for stage IA, 47.0% for IB1, 18.9% for IB2, and 19.7% for II-IV. For treatment during pregnancy, 17.4% of the patients underwent surgery, 16.7% received neoadjuvant chemotherapy, 26.5% delayed their treatment, 12.9% had a premature delivery, and 26.5% had their pregnancy terminated. Median follow-up was 84 months (67 months for pregnant and 95 months for non-pregnant patients). The unadjusted hazard ratio of pregnancy for progression-free survival was 1.18 (95% confidence interval 0.74 to 1.88).ConclusionSurgery and chemotherapy is increasingly used in the management of pregnant patients with cervical cancer and prognosis is similar to that of non-pregnant patients.
- Published
- 2019
97. Gynecologic cancers in pregnancy: guidelines based on a third international consensus meeting
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Paul Berveiller, K. Van Calsteren, Ingrid A. Boere, Tineke Vandenbroucke, Michael J. Halaska, Charlotte Maggen, Matteo Lambertini, P. Poortmans, Robert Fruscio, Christianne A.R. Lok, Monica Fumagalli, M. van Gerwen, Frédéric Amant, M.M. van den Heuvel-Eibrink, Annette Hasenburg, Elyce Cardonick, Ignacio Zapardiel, A.L.V. Johansson, P. Morice, Flora Zagouri, Fedro A. Peccatori, Medical Oncology, Amant, F, Berveiller, P, Boere, I, Cardonick, E, Fruscio, R, Fumagalli, M, Halaska, M, Hasenburg, A, Johansson, A, Lambertini, M, Lok, C, Maggen, C, Morice, P, Peccatori, F, Poortmans, P, Van Calsteren, K, Vandenbroucke, T, van Gerwen, M, van den Heuvel-Eibrink, M, Zagouri, F, Zapardiel, I, Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Gamètes, implantation, gestation (GIG), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Erasmus University Medical Center [Rotterdam] (Erasmus MC), Università degli Studi di Milano-Bicocca [Milano] (UNIMIB), Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, University Hospital Kralovské Vinohrady, University Medical Center [Mainz], Karolinska Institutet [Stockholm], Ospedale Policlinico San Martino [Genoa], Netherlands Cancer Institute (NKI), Antoni van Leeuwenhoek Hospital, Département de chirurgie gynécologique [Gustave Roussy], Institut Gustave Roussy (IGR), European Institute of Oncology [Milan] (ESMO), Université Paris sciences et lettres (PSL), University Hospitals Leuven [Leuven], VU University Medical Center [Amsterdam], Princess Máxima Center for Pediatric Oncology [Utrecht, Netherlands], University of Athens Medical School [Athens], Hospital Universitario La Paz, Obstetrics, and Faculty of Economic and Social Sciences and Solvay Business School
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0301 basic medicine ,medicine.medical_specialty ,Cognitive ,Genital Neoplasms, Female ,International Cooperation ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Cancer, Chemotherapy, Cognitive, Gynecologic, Offspring, Pregnancy ,[SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics ,03 medical and health sciences ,Genital Neoplasms, Female/therapy ,Gynecologic ,Offspring ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,Pregnancy ,Health care ,medicine ,Prenatal Exposure Delayed Effects/etiology ,Humans ,Chemotherapy ,Radiation treatment planning ,Intensive care medicine ,Societies, Medical ,Cancer ,Pregnancy Complications, Neoplastic/therapy ,Vaginal delivery ,business.industry ,Hematology ,medicine.disease ,Prognosis ,3. Good health ,Cancer registry ,Long-term care ,030104 developmental biology ,Oncology ,030220 oncology & carcinogenesis ,Prenatal Exposure Delayed Effects ,Practice Guidelines as Topic ,Female ,Practice Guidelines as Topic/standards ,business ,Breast feeding ,Pregnancy Complications, Neoplastic - Abstract
We aimed to provide comprehensive protocols and promote effective management of pregnant women with gynecological cancers. New insights and more experience have been gained since the previous guidelines were published in 2014. Members of the International Network on Cancer, Infertility and Pregnancy (INCIP), in collaboration with other international experts, reviewed existing literature on their respective areas of expertise. Summaries were subsequently merged into a manuscript that served as a basis for discussion during the consensus meeting. Treatment of gynecological cancers during pregnancy is attainable if management is achieved by collaboration of a multidisciplinary team of health care providers. This allows further optimization of maternal treatment, while considering fetal development and providing psychological support and long-term follow-up of the infants. Nonionizing imaging procedures are preferred diagnostic procedures, but limited ionizing imaging methods can be allowed if indispensable for treatment plans. In contrast to other cancers, standard surgery for gynecological cancers often needs to be adapted according to cancer type and gestational age. Most standard regimens of chemotherapy can be administered after 14 weeks gestational age but are not recommended beyond 35 weeks. C-section is recommended for most cervical and vulvar cancers, whereas vaginal delivery is allowed in most ovarian cancers. Breast-feeding should be avoided with ongoing chemotherapeutic, endocrine or targeted treatment. More studies that focus on the long-term toxic effects of gynecologic cancer treatments are needed to provide a full understanding of their fetal impact. In particular, data on targeted therapies that are becoming standard of care in certain gynecological malignancies is still limited. Furthermore, more studies aimed at the definition of the exact prognosis of patients after antenatal cancer treatment are warranted. Participation in existing registries (www.cancerinpregnancy.org) and the creation of national tumor boards with multidisciplinary teams of care providers (supplementary Box S1, available at Annals of Oncology online) is encouraged. ispartof: ANNALS OF ONCOLOGY vol:30 issue:10 pages:1601-1612 ispartof: location:England status: published
- Published
- 2019
98. Ovarian cancer in pregnancy
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Robert Fruscio, Frédéric Amant, Mina Mhallem, Kristel Van Calsteren, Magali Verheecke, Jorine de Haan, Fruscio, R, de Haan, J, Van Calsteren, K, Verheecke, M, Mhallem, M, Amant, F, ARD - Amsterdam Reproduction and Development, and Obstetrics and gynaecology
- Subjects
Oncology ,medicine.medical_specialty ,endocrine system diseases ,Paclitaxel ,medicine.medical_treatment ,Gestational Age ,Malignancy ,Bleomycin ,Carboplatin ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Ovarian cancer ,Pregnancy ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Neoplasms, Glandular and Epithelial ,Neoadjuvant therapy ,Neoplasm Staging ,Ovarian Neoplasms ,Chemotherapy ,030219 obstetrics & reproductive medicine ,business.industry ,Gestational age ,Obstetrics and Gynecology ,Patient Preference ,General Medicine ,medicine.disease ,female genital diseases and pregnancy complications ,Neoadjuvant Therapy ,Chemotherapy in pregnancy ,chemistry ,Chemotherapy, Adjuvant ,030220 oncology & carcinogenesis ,Surgery in pregnancy ,Female ,business ,Pregnancy Complications, Neoplastic - Abstract
Although the occurrence of ovarian masses in pregnancy is relatively common, the majority of them is functional and resolve spontaneously; nevertheless, ovarian cancer is the fifth most common malignancy diagnosed in pregnancy. If malignancy is suspected, treatment should be decided on the basis of gestational age, stage of the disease and patient preferences. In early stage, ovarian cancer surgery may be planned preferably after 16 weeks of pregnancy, and chemotherapy can be administered from the second trimester if indicated as in nonpregnant patients. In advanced-stage disease, when complete cytoreduction is not achievable, neoadjuvant chemotherapy could be administered even in pregnancy. Chemotherapy should be a combination of carboplatin and paclitaxel in epithelial ovarian cancer patients and a combination of cisplatin, vinblastin and bleomycin in non-epithelial ovarian cancer. The outcome of patients with ovarian cancer diagnosed in pregnancy is similar to non-pregnant patients, and stage of the disease is the most important prognostic factor. (C) 2016 Published by Elsevier Ltd
- Published
- 2017
99. Melanoma during pregnancy: a report of 60 pregnancies complicated by melanoma
- Author
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Wojciech Kolawa, Marianne B. Crijns, Sevilay Altintas, Christianne A. R. Lok, Jorine de Haan, Karina Dahl Steffensen, Kristel Van Calsteren, Michael J. Halaska, Christianne J.M. de Groot, Petronella O. Witteveen, Frédéric Amant, Ingrid A. Boere, Robert Fruscio, Medical Oncology, ARD - Amsterdam Reproduction and Development, Other departments, De Haan, J, Lok, C, De Groot, C, Crijns, M, Van Calsteren, K, Dahl Steffensen, K, Halaska, M, Altintas, S, Boere, I, Fruscio, R, Kolawa, W, Witteveen, P, Amant, F, Int Network Canc Infertility Preg, Obstetrics and gynaecology, Amsterdam Reproduction & Development (AR&D), and CCA - Cancer Treatment and quality of life
- Subjects
Adult ,Infertility ,medicine.medical_specialty ,Cancer Research ,medicine.medical_treatment ,Disease ,Dermatology ,Cohort Studies ,Young Adult ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,medicine ,melanoma ,Journal Article ,Humans ,cancer ,Stage (cooking) ,Gynecology ,Pregnancy ,business.industry ,Obstetrics ,Melanoma ,Incidence (epidemiology) ,Pregnancy Outcome ,Cancer ,medicine.disease ,Survival Rate ,Radiation therapy ,Oncology ,030220 oncology & carcinogenesis ,Female ,Human medicine ,pregnancy ,Neoplasm Recurrence, Local ,business ,preterm ,Pregnancy Complications, Neoplastic ,Follow-Up Studies - Abstract
The management of melanoma during pregnancy is challenging as maternal benefits and fetal risks need to be balanced. Here, we present an overview of the incidence, the demographic and clinical characteristics and the treatment modalities used. After analysis of obstetric, fetal and maternal outcome, recommendations for clinical practice are provided. From the 'International Network on Cancer, Infertility and Pregnancy' database, pregnant patients with melanoma were identified and analysed. Sixty pregnancies were eligible for analysis. Fifty percent of the patients presented with advanced melanoma during pregnancy (14 stage III and 16 stage IV), and 27% were diagnosed with recurrent melanoma. Surgery was the main therapeutic strategy during pregnancy. Only four patients with advanced melanoma were treated during pregnancy with systemic therapy (n=1) or radiotherapy (n=3). Premature delivery was observed in 18% of the ongoing pregnancies, all which were induced and 78% of which involved patients with advanced melanoma. Thirty-nine percent of the patients died within 5 years; all had been diagnosed with stage III or IV disease during pregnancy. Melanoma can present in a more advanced stage during pregnancy. New systemic therapies may be beneficial for patients with metastatic melanoma but may not be pregnancy compatible. In these patients, preterm induction of labour need to be discussed, despite the short-term and long-term negative effects on the child. ispartof: Melanoma Research vol:27 issue:3 pages:218-223 ispartof: location:England status: published
- Published
- 2017
100. Gynecologic Cancers in Pregnancy Guidelines of a Second International Consensus Meeting
- Author
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Amant, F., Halaska, M.J., Fumagalli, M., Dahl Steffensen, K., Lok, C., Calsteren, K. van, Han, S.N., Mir, O., Fruscio, R., Uzan, C., Maxwell, C., Dekrem, J., Strauven, G., Mhallem Gziri, M., Kesic, V., Berveiller, P., Heuvel, F. van den, Ottevanger, P.B., Vergote, I., Lishner, M., Morice, P., Nulman, I., Amant, F, Halaska, M, Fumagalli, M, Dahl Steffensen, K, Lok, C, Van Calsteren, K, Han, S, Mir, O, Fruscio, R, Uzan, C, Maxwell, C, Dekrem, J, Strauven, G, Mhallem Gziri, M, Kesic, V, Berveiller, P, van den Heuvel, F, Ottevanger, P, Vergote, I, Lishner, M, Morice, P, and Nulman, I
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medicine.medical_specialty ,Consensus ,Genital Neoplasms, Female ,MED/40 - GINECOLOGIA E OSTETRICIA ,Antineoplastic Agents ,law.invention ,Gynecologic ,Randomized controlled trial ,law ,Pregnancy ,medicine ,Chemotherapy ,Humans ,Intensive care medicine ,Prospective cohort study ,Cancer ,Cervical cancer ,Gynecology ,business.industry ,Endometrial cancer ,Obstetrics and Gynecology ,Gestational age ,Evidence-based medicine ,medicine.disease ,Delivery, Obstetric ,Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] ,Oncology ,Female ,pregnancy ,Neonatology ,business ,Pregnancy Complications, Neoplastic - Abstract
ObjectivesThis study aimed to provide timely and effective guidance for pregnant women and health care providers to optimize maternal treatment and fetal protection and to promote effective management of the mother, fetus, and neonate when administering potentially teratogenic medications. New insights and more experience were gained since the first consensus meeting 5 years ago.MethodsMembers of the European Society of Gynecological Oncology task force “Cancer in Pregnancy” in concert with other international experts reviewed the existing literature on their respective areas of expertise. The summaries were subsequently merged into a complete article that served as a basis for discussion during the consensus meeting. All participants approved the final article.ResultsIn the experts’ view, cancer can be successfully treated during pregnancy in collaboration with a multidisciplinary team, optimizing maternal treatment while considering fetal safety. To maximize the maternal outcome, cancer treatment should follow a standard treatment protocol as for nonpregnant patients. Iatrogenic prematurity should be avoided. Individualization of treatment and effective psychologic support is imperative to provide throughout the pregnancy period. Diagnostic procedures, including staging examinations and imaging, such as magnetic resonance imaging and sonography, are preferable. Pelvic surgery, either open or laparoscopic, as part of a treatment protocol, may reveal beneficial outcomes and is preferably performed by experts. Most standard regimens of chemotherapy can be administered from 14 weeks gestational age onward. Apart from cervical and vulvar cancer, as well as important vulvar scarring, the mode of delivery is determined by the obstetrician. Term delivery is aimed for. Breast-feeding should be considered based on individual drug safety and neonatologist–breast-feeding expert’s consult.ConclusionsDespite limited evidence-based information, cancer treatment during pregnancy can succeed. State-of-the-art treatment should be provided for this vulnerable population to preserve maternal and fetal prognosis.Supplementary InformationSupplementary data on teratogenic effects, ionizing examinations, sentinel lymph node biopsy, tumor markers during pregnancy, as well as additional references and tables are available at the extended online version of this consensus article, go tohttp://links.lww.com/IGC/A197.
- Published
- 2014
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