Choriocarcinoma

Brewer, John I.; Smith, Roy T.; Pratt, George B.

doi:10.1016/s0002-9378(16)35583-1

Cited by 68 publications

(2 citation statements)

References 2 publications

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“…Approximately half to two-third of patients with high-risk GTN need surgery during the course of therapy to remove disease or treat complications [ 6 7 8 ]. Lewis et al [ 9 ] reported that the most common surgery was for hemorrhage control.…”

Section: Discussionmentioning

confidence: 99%

Role of surgical therapy in the management of gestational trophoblastic neoplasia

et al. 2015

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ObjectiveTo evaluate the role of adjuvant surgical procedures in the management of gestational trophoblastic neoplasia (GTN).MethodsIn a retrospective review of medical records at the Severance Hospital, we identified 174 patients diagnosed with GTN between 1986 and 2006. Of the 174 patients, 129 (74%) were assigned to the nonmetastatic group, and 45 (26%) to the metastatic group; of the metastatic group patients, 6 were in the low-risk group and 39 were in the high-risk group. Thirty-two patients underwent 35 surgical procedures as part of the GTN treatment. The procedures included hysterectomy, lung resection, craniotomy, uterine wedge resection, uterine suturing for bleeding, salpingo-oophorectomy, pretherapy dilatation and curettage, adrenalectomy, nephrectomy, and uterine artery embolization.ResultsOf the 32 patients who underwent surgical procedures, 28 (87%) survived. Eleven patients underwent surgery for chemoresistant disease after receiving one or more chemotherapy regimens. Twelve patients underwent procedures to control tumor hemorrhage. Nine (81%) of 11 patients with chemoresistant disease survived, and 8 patients who underwent salvage surgery for chemoresistant disease received further chemotherapy. Of 21 patients who underwent hysterectomy, 19 (90%) achieved remission. All of three patients who had resistant foci of choriocarcinoma in the lung achieved remission through pulmonary resection.ConclusionAdjuvant surgical procedures, especially hysterectomy and pulmonary resection for chemoresistant disease, as well as procedures to control hemorrhage, are pivotal in the management of GTN.

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Section: Discussionmentioning

confidence: 99%

Role of surgical therapy in the management of gestational trophoblastic neoplasia

et al. 2015

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“…Although chemotherapy is highly effective for treatment of GTN, hysterectomy has an important role in the management of some patient with malignant GTN, especially when the disease is localised or confined to the uterus. The first large series on 122 patients with choriocarcinoma treated with hysterectomy was reported by Brewer et al in 1963 [ 43 ]. This series included 70 patients (57.4%) with localised disease with 5-year survival of 41.5% compared to 19.2% in patients with metastatic disease.…”

Section: Surgery For Malignant Gestational Trophoblastic Neoplasiamentioning

confidence: 99%

Surgery including fertility-sparing treatment of GTD

Ngu

Ngan

2021

Best Practice & Research Clinical Obstetrics & Gynaecol

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Gestational trophoblastic disease (GTD) consist of a spectrum of diseases, including hydatidiform moles, invasive mole, metastatic mole, choriocarcinoma, placental site trophoblastic tumour (PSTT) and epithelioid trophoblastic tumour (ETT). GTD are relatively uncommon disease occurring in women of reproductive age, with high cure rates. Primary treatment of hydatidiform moles includes uterine evacuation, followed by close monitoring of serial hCG levels to detect for post-molar gestational trophoblastic neoplasia (GTN). In patients with GTN, the main therapy consists of chemotherapy, although some surgical procedures are important in selected patients in order to achieve cure. Hysterectomy is the mainstay treatment for PSTT or ETT, and may be considered in selected patients for management of hydatidiform mole and malignant GTN especially in chemoresistant disease. Resection of metastatic lesions such as in the lung or brain can be considered in selected patients with isolated chemoresistant tumour. Surgical treatment of GTD will be discussed in this chapter.

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Incidence of choriocarcinoma in Puerto Rico:A 15-year study

Aranda

Martinez

1969

Cancer

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From 1950 to 1965, 42 cases of choriocarcinoma were reported to the Central Cancer Registry of Puerto Rico. The malignancy was definitely related to preceding pregnancy in 40 of the reported cases. The incidence of choriocarcinoma in Puerto Rico appears similar to reported estimates from the United States, but it is apparently much lower than frequencies reported from Asian countries. Special prenatal care and postpartum follow‐up are recommended for patients over 40 years of age.

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Choriocarcinoma

Cited by 68 publications

References 2 publications

Role of surgical therapy in the management of gestational trophoblastic neoplasia

Role of surgical therapy in the management of gestational trophoblastic neoplasia

Surgery including fertility-sparing treatment of GTD

Incidence of choriocarcinoma in Puerto Rico:A 15-year study

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