Author reply

Abstract

The comments by Drs. Giacalone and Laffargue are appreciated. However, two points need to be addressed. Drs. Giacolone and Laffargue state that in our abstract conclusion we claim that our report constitutes the first description of the use of neoadjuvant chemotherapy for cervical carcinoma in pregnancy, but if the abstract conclusion is read carefully, we stated that to our knowledge, these cases constituted the first description of the use of neoadjuvant chemotherapy for invasive squamous cell carcinoma of the cervix in pregnancy.1 We are fully aware of the report by Jacobs et al. in 1980, but these investigators were describing the management of a neuroendocrine or oat cell cervical carcinoma, not a squamous cell cancer.2 (In point of fact, we recently published an account of neuroendocrine carcinoma in pregnancy3 and have included the reference of Jacobs et al.) Second, our article was prepared during the first half of 1997 and submitted for consideration for publication in Cancer in June 1997. The article written by Giacalone et al. appeared in September 19964 but was not referenced through MEDLINE at the time we were preparing our article. We occasionally have noted a delay in the entry of case reports and research letters to the MEDLINE database. As an example, one of our articles was published in the February 1998 issue of The Lancet,5 but did not appear in the MEDLINE database until October 1998. We acknolwedge the significance of the report by Giacalone et al. The second patient in our article was treated in 1995 and therefore it is reasonable to assume that both groups (ours and Giacalone et al.) treated similar patients with neoadjuvant chemotherapy during the same period. It is our opinion that both reports are noteworthy contributions and attest to the importance of this treatment option for women with locally advanced disease who refuse to interrupt their pregnancies. Because we have an interest in the management of cancer in pregnancy, we look forward to further communications on this subject. Krishnansu Tewari M.D.*, Philip J. DiSaia M.D.*, * Division of Gynecologic Oncology, University of California, Irvine, Medical Center, Orange, California