Gestational trophoblastic disease: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Seckl, Michael J.; Sebire, Neil J.; Fisher, Rosemary A.; Golfier, François; Massuger, Leon F.A.G.; Sessa, Cristiana

doi:10.1093/annonc/mdt345

Cited by 315 publications

(455 citation statements)

References 42 publications

Supporting

Mentioning

407

Contrasting

Unclassified

Order By: Relevance

“…For nearly all low risk GTN patients, single agent chemotherapy with either MTX or Act-D is the preferred treatment. 1,2,5,7,20 A variety of regimens have been developed, in which non-randomized, mostly retrospective studies demonstrate a 50-90% chance of inducing remissiion. 21 Multiple agent chemotherapy should be used primarily in all high risk GTN patients.…”

Section: Discussionmentioning

confidence: 99%

“…1 Most of the GTD cases include two types of hydatidiform moles (HM) that have a variable potential to progress into the rare malignant disease gestational trophoblastic neoplasia (GTN). 2,3 GTN is among rare human tumours that can be cured, with an overall 90% of patient survival, due to the inherent chemotherapy sensitivity of trophoblastic neoplasms, the effective use of the tumour marker beta human chorionic gonadotrophin (βhCG) for diagnosis of disease and monitoring of therapy and the identification of prognostic factors that enhances individualization of chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

“…2,3 GTN is among rare human tumours that can be cured, with an overall 90% of patient survival, due to the inherent chemotherapy sensitivity of trophoblastic neoplasms, the effective use of the tumour marker beta human chorionic gonadotrophin (βhCG) for diagnosis of disease and monitoring of therapy and the identification of prognostic factors that enhances individualization of chemotherapy. [1][2][3][4][5][6][7] The objective of this study was to determine the clinical presentation of GTD and response of GTN to single and multiple agent chemotherapy on the basis of WHO Prognostic risk scoring system.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Trends of Gestational Trophoblastic Disease at a Tertiary Care Hospital

Shakya¹,

Baral

2018

Nepal j. obstet. gynaecol.

View full text Add to dashboard Cite

Aims:The objective of this study was to determine the clinical presentation of GTD and response of GTN to single and multiple agent chemotherapy on the basis of WHO Prognostic risk scoring system. Methods:This was a cross-sectional retrospective study undertaken at Paropakar Maternity and Women's Hospital. The medical records of 102 GTD cases were reviewed from January 25, 2015 to January 24, 2016. Data pertaining patient characteristics, histopathology types of GTD, management, prognostic risk scores, chemotherapy, follow up and remissions were retrieved and were analyzed using SPSS version 16.0.Results: Among 102 GTD cases, the most common presentation was vaginal bleeding 69(67.6%) followed by ultrasound diagnosed cases 30(29.4%). Primary management of all cases were suction evacuation, 68 completed and 12 are under follow-up. GTN was diagnosed in 14/90 (15.5%) of complete mole and 5/90 (5.5%) of partial mole. Twenty-two cases received chemotherapy for persistent gestational trophoblastic tumour(19) and invasive mole(3). Twenty cases were low risk score group and two cases under high risk group. Out of 20 low risk cases that received MTX-FA, 13/20 (65%) achieved remission. Due to low response of MTX-FA, five of them were converted to Actinomycin-D and achieved remission(100%). Two high risk cases received EMA-CO regimen and achieved 100% remission. Two low risk GTN, complete and invasive mole (underwent hysterectomy) are undergoing MTX-FA chemotherapy. Conclusions:The most common presentation of GTD was vaginal bleeding. Low risk GTN achieved 65% remission with Methotrexate-Folinic acid, ultimately achieved 100% remission with Actinomycin-D. High risk GTN achieved 100% remission with EMA-CO regimen.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Trends of Gestational Trophoblastic Disease at a Tertiary Care Hospital

Shakya¹,

Baral

2018

Nepal j. obstet. gynaecol.

View full text Add to dashboard Cite

show abstract

“…De hecho, no se aconseja la realización de una biopsia tumoral o de la lesión metastática si no existe garantía de controlar el sangrado, ya que son lesiones con una gran vascularización, en nuestro caso fue una de las razones por las que no realizamos biopsia. Existen casos publicados en los que, tras la realización de una biopsia, ésta no es diagnostica de CC debido al importante componente necrótico y hemorrágico del tumor (2,8,9,10).…”

Section: Discussionunclassified

Coriocarcinoma postgestacional

et al. 2015

Rev. chil. obstet. ginecol.

View full text Add to dashboard Cite

RESUMENEl coriocarcinoma es una patología infrecuente pero potencialmente fatal si no se trata. Se incluye dentro de las neoplasias trofoblásticas gestacionales, un grupo de tumores malignos altamente invasivos, metastáticos y muy vascularizados. Su presentación tras una gestación a término conlleva peor pronóstico que tras un aborto o una mola hidatiforme porque refleja un retraso en el diagnóstico y tratamiento. Describimos el caso de una paciente que acudió al servicio de urgencias, refiriendo metrorragia escasa desde un parto normal hace dos meses y posteriormente presentó un sangrado grave durante su hospitalización. Los elevados niveles de β-hCG, la ecografía-Doppler, las pruebas de imagen y las manifestaciones clínicas fueron suficientes para diagnosticar un coriocarcinoma postparto. El tratamiento precoz con poliquimioterápicos permitió una evolución favorable de la paciente. PALABRAS CLAVE: Enfermedad trofoblástica gestacional, coriocarcinoma, embarazo SUMMARYChoriocarcinoma is an infrequent disease but potentially fatal if untreated. It is included in trophoblastic gestational neoplasia, a range of malignant tumors highly invasive, metastatic and very vascular. Its presentation after term pregnancies carries a worse prognosis than after a miscarriage or a hydatidiform mole because it reflects a delay in diagnosis and treatment. We report the case of a patient who presented to the emergency department referring little metrorrhagia from a normal delivery two months ago and severe bleeding later during her hospital stay. The high serum β-hCG level, the Doppler ultrasonography, the imaging test and the clinical manifestation were enough to diagnose a non-metastatic postpartum choriocarcinoma. Early treatment with polychemotherapy allowed a favorable evolution of the patient. KEY WORDS: Gestational trophoblastic disease, choriocarcinoma, pregnancy INTRODUCCIÓNEl coriocarcinoma (CC) es un tumor epitelial maligno derivado de las vellosidades coriales, productor de gonadotropina coriónica humana (β-hCG) que se incluye dentro de la enfermedad trofoblás-tica maligna (ETM), junto a la mola invasiva y al tumor trofoblástico del lecho placentario (1). Todos ellos se caracterizan por su gran capacidad invasiva, debido a un fallo en el mecanismo regulador de la invasión del tejido trofoblástico a la decidua y su rica vascularización, la cual condiciona su extensión vía vascular (2,3).La incidencia del CC en Europa y Norteamérica se estima en 3/100.000 gestaciones (1), mientras que en Asia estos valores ascienden a 5-200/100.000 embarazos. Estas diferencias se han asociado a la utilización de diferentes clasificaciones histológicas, la dieta o condicionantes genéticos (2,4).La clínica principal es la metrorragia, tanto en las etapas iniciales de la gestación como en el pos-REV CHIL OBSTET GINECOL 2015; 80(5): 405 -411

show abstract

“…23 The rates of survival of low-risk patients treated with monotherapy are around 100% while highrisk patients after polychemotherapy are 87%. 24 PSTT is usually confined to the uterus, but considering its characteristic resistance to chemotherapy there are few long-term survivors with disease PSTT.…”

Section: Managementmentioning

confidence: 99%

Distinct gestational trophoblastic neoplasia - different entities, specific management

Brandão

Silva-Rocha

Pinto

et al. 2017

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Gestational trophoblastic diseases are abnormalities of the trophoblastic tissue development. They have Β-hCG as tumour marker, similar clinical manifestations but different pathological features, management and prognosis. Gestational trophoblastic neoplasia includes all forms of gestational trophoblastic disease that are invasive and/or metastasize and correspond to 10% of this group of diseases. The authors performed a retrospective review of all patients referred to our department between 1st January 2011 and 30th June 2016. Presenting symptoms, Β-hCG levels, obstetric and personal history and microscopic features were reviewed. 4 cases were identified - 2 invasive complete and 1 partial hydatidiform moles and 1 placental site trophoblastic tumour. Management and follow-up were individualized. Neither persistence nor recurrences were diagnosed after primary treatment. These case series highlights the importance of an accurate diagnosis and a long-term follow-up considering the risk of persistency or malignancy, as gestational trophoblastic neoplasia usually have good response to the adequate therapy.

show abstract

Gestational trophoblastic disease: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Cited by 315 publications

References 42 publications

Trends of Gestational Trophoblastic Disease at a Tertiary Care Hospital

Trends of Gestational Trophoblastic Disease at a Tertiary Care Hospital

Coriocarcinoma postgestacional

Distinct gestational trophoblastic neoplasia - different entities, specific management

Contact Info

Product

Resources

About