Metastatic Lung Choriocarcinoma Resected Nine Years after Hydatidiform Mole

Suzuki, Takashi; Kitami, Akihiko; Hori, G; Notake, Y; Mitsuya, Toshiyuki; Sagawa, F

doi:10.1080/14017439950141830

Cited by 5 publications

(3 citation statements)

References 8 publications

(10 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is well known that radiological evidence of tumor regression is slower than hCG regression and normalization. Some patients will have remaining lung nodules with non-vital trophoblast tissue several months after completion of chemotherapy [70]. Although patients with pulmonary lesions have a higher risk of disease recurrence, it does not clearly influence prognosis, and persistent lung lesions with normal hCG levels could be safely monitored without the need of surgical resection [71][72][73][74][75].…”

Section: Surgery In Gtdmentioning

confidence: 99%

Surgical Management of Gestational Trophoblastic Disease

Coopmans,

Larsson,

Joneborg

et al. 2023

Gynecol Obstet Invest

View full text Add to dashboard Cite

Background Gestational Trophoblastic Disease (GTD) is a rare pregnancy related condition consisting of premalignant and malignant forms arising from proliferation of trophoblastic cells. The malignant forms are collectively referred to as Gestational Trophoblastic Neoplasia (GTN) and are highly sensitive to chemotherapy. However, surgical procedures remain indispensable in the diagnosis and treatment of GTD. Objectives The aim of this review is to summarize surgical interventions in the treatment of GTD and GTN. We reviewed indications, efficacy, possible complications and oncological outcomes of surgery. Methods Three searches were performed in the databases of PubMed, Embase and the Cochrane Library to create an up-to-date overview of existing literature on the following subjects: 1. The role of primary hysterectomy in GTD and GTN 2. The role of second curettage in GTD and GTN 3. Fertility sparing surgery in GTN 4. Surgical management of metastases. Included articles originated from the time period 1952-2022. Articles written in English, Spanish and French were included. Outcomes Thirty-eight articles were found and selected. Surgical evacuation through suction curettage is most used and advised in the treatment of GTD. A second curettage could be beneficial in patients with low hCG levels and low FIGO scores. In women who have completed their families, primary hysterectomy might be considered as the risk of subsequent GTN is lower than after suction curettage. In case of the rare forms of GTN (Epithelioid Trophoblastic Tumor (ETT) or Placental Site Trophoblastic Tumor (PSTT)) surgical tumor resection remains the most important step in treatment. Data on fertility sparing surgery in GTN are scarce and this treatment should be considered experimental. Conclusion and Outlook Surgery remains an important part of treatment of GTD and is sometimes indispensable to achieve curation. Further collection of evidence is needed to determine treatment steps.

show abstract

Section: Surgery In Gtdmentioning

confidence: 99%

Surgical Management of Gestational Trophoblastic Disease

Coopmans,

Larsson,

Joneborg

et al. 2023

Gynecol Obstet Invest

View full text Add to dashboard Cite

show abstract

“…Fortunately, majority of patients do not require lung resection because most can be treated with chemotherapy alone. Notably, the radiographic evidence of tumour regression usually lags behind hCG levels response, with some patients having persistent pulmonary nodules for months or years after completing chemotherapy [ 66 , 67 ]. The overall risk of recurrence in low-risk metastatic GTN is typically less than 5% [ 53 ].…”

Section: Surgery For Metastatic Tumoursmentioning

confidence: 99%

“…The overall risk of recurrence in low-risk metastatic GTN is typically less than 5% [ 53 ]. Although patients with pulmonary lesions that persisted after normalisation of hCG levels may be at higher risk of recurrence[ 67 ], these patients can be safely monitored using serial hCG without resorting to surgical resection [ 68 ].…”

Section: Surgery For Metastatic Tumoursmentioning

confidence: 99%

Surgery including fertility-sparing treatment of GTD

Ngu

Ngan

2021

Best Practice & Research Clinical Obstetrics & Gynaecol

View full text Add to dashboard Cite

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.

show abstract