Table 6.

Ovarian cancer during pregnancy: basic principles of management.

A multidisciplinary team is mandatory. Pregnant women should be informed, in great detail, about the benefits and risks of treatment. Patients’ beliefs and wishes should be acknowledged. The management of pregnant patients should take into consideration the physiological changes during pregnancy. Numerous imaging procedures using radiography are not harmful to the fetus when they are used with proper shielding. Laparoscopic or open surgery can be safe, providing they are executed by “proper hands”. Systemic chemotherapy should be started from the second trimester if possible. Most chemotherapeutics are safe during the second and third trimesters. There is no evidence based medicine about targeted therapies. The doses of medicaments should be the same for pregnant women as for non-pregnant women. Radiotherapy is contraindicated during pregnancy. Termination of pregnancy may be considered in the case of immediate treatment. No change in prognosis has been shown after the termination of pregnancy. Differences in the rates of survival may exist between pregnant and non-pregnant women with cancer. There is no evidence that subsequent pregnancy increases the risk of recurrence of the disease.