NESS - Contemporary Analysis of Malignancies in Women of Child-Bearing Age: An NSQIP analysis

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Contemporary Analysis of Malignancies in Women of Child-Bearing Age: An NSQIP analysis
*Eva Rouanet, *Ann-Kristin Friedrich, *Kate Dinh, *Kevin Baratta, Giles F Whalen, *Heena Santry, Jennifer LaFemina
University of Massachusetts Medical School, Worcester, MA

OBJECTIVE: This study aims to assess whether there is a difference in the distribution of surgical resections of malignancy between pregnant and non-pregnant women.
DESIGN: Retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2005 to 2012. Chi-square tests and student’s t-tests were used to compare categorical and continuous variables, respectively. Logistic regression analysis adjusted for age, was performed for all variables.
SETTING: National cohort of patients registered in ACS NSQIP.
PATIENTS OR OTHER PARTICIPANTS: Female patients aged 18-49 years with a ICD-9 diagnosis of “neoplasm” (codes 140-239) were included. Patients without a documented pregnancy status were excluded.
INTERVENTIONS: Patients who underwent surgical resection for malignancy were analyzed based on pregnancy status.
MAIN OUTCOME MEASURES: Determine if there are differences in distribution of resections for cancer between pregnant and non-pregnant population.
RESULTS: 42,732 subjects with malignancies surgically treated during child-bearing age were identified. 0.33% (n=143) were pregnant. The most common tumors requiring resection during pregnancy were breast (45%), thyroid (31%), and colorectal (2%). The distribution for most cancers was similar between groups. The age-adjusted odds ratio was significantly increased in breast, major salivary gland and oropharyngeal malignancies (p<0.05). The proportion of resected colorectal cancers was significantly lower in pregnant women (p<0.05).
CONCLUSION: This study serves as the first contemporary overview of malignancies resected in women of childbearing age. This study demonstrates that the age-adjusted proportion of resections among pregnant women was significantly greater in breast, major salivary gland and oropharyngeal cancers and lower for colorectal cancers.

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