The added value of hysterectomy in the management of gestational trophoblastic neoplasia

Eysbouts, Y.K.; Massuger, Leon F.A.G.; IntHout, Joanna; Lok, Christianne; Sweep, Fred C.G.J.; Ottevanger, Petronella B.

doi:10.1016/j.ygyno.2017.03.018

Cited by 30 publications

(26 citation statements)

References 30 publications

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“…Surgery also plays an important role in the management of patients with recurrent GTN. Previous studies have shown that salvage surgery is an effective adjunct curative treatment for patients with GTN who are resistant to chemotherapy . As most GTN recurrences are caused by chemoresistant disease, resection of the chemoresistant tumor in the uterus, lung, liver, or other organs should be considered upon GTN recurrence.…”

Section: Discussionmentioning

confidence: 99%

Management and risk factors of recurrent gestational trophoblastic neoplasia: An update from 2004 to 2017

et al. 2020

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Objective We investigated the clinical characteristics, treatments, and survival of patients with gestational trophoblastic neoplasia (GTN) who experienced recurrence. Factors predictive of recurrence were also investigated. Methods Patients with GTN who recurred after completing chemotherapy at Peking Union Medical College Hospital Trophoblastic Disease Center were identified between January 2004 and December 2017. Logistic regression analysis was used to identify factors predictive of GTN recurrence. Results A total of 1827 patients with GTN achieved complete remission (CR) at our center, of whom 118 (6.5%) experienced recurrence during follow‐up. The recurrence rates for patients initially treated at our center and those referred to us were 2.7% and 14.6%, respectively. The majority of recurrent patients received floxuridine‐based multiagent chemotherapy (n = 64). Patients who underwent surgery achieved a significantly higher CR rate than those who did not (88.6% vs 61.1%, P = .001). Although 94.1% of recurrent patients reachieved CR, 33.3% of them recurred for a second time. The 5‐year survival rate of the entire cohort was 80.4%. An interval between antecedent pregnancy and chemotherapy >12 months (OR: 6.600, 95% CI [3.217‐13.540], P < .001), and an interval from first chemotherapy to achieving β‐human chorionic gonadotropin (β‐hCG) normalization >14 weeks (OR: 2.226, 95% CI [1.080‐4.588], P = .030) were predictors of recurrence. Conclusions Patients with recurrent GTN are prone to recurring for a second time. Surgery plays a beneficial role in the management of recurrent GTN. An interval between antecedent pregnancy and chemotherapy >12 months, and an interval from first chemotherapy to achieving β‐hCG normalization >14 weeks were predictors of recurrence.

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Section: Discussionmentioning

confidence: 99%

Management and risk factors of recurrent gestational trophoblastic neoplasia: An update from 2004 to 2017

et al. 2020

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“…Repeat dilation and curettage or hysterectomy can be considered for persistent postmolar GTN. [24][25][26] An observational study conducted over 10 years examined 544 women who underwent second uterine evacuation for persistent GTD. 26 Following repeat curettage, 68% had no further evidence of disease or chemotherapy requirements.…”

Section: Postmolar Gtnmentioning

confidence: 99%

Gestational Trophoblastic Neoplasia, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology

Abu‐Rustum

Yashar

Bean

et al. 2019

Journal of the National Comprehensive Cancer Network

101

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Gestational trophoblastic neoplasia (GTN), a subset of gestational trophoblastic disease (GTD), occurs when tumors develop in the cells that would normally form the placenta during pregnancy. The NCCN Guidelines for Gestational Trophoblastic Neoplasia provides treatment recommendations for various types of GTD including hydatidiform mole, persistent post-molar GTN, low-risk GTN, high-risk GTN, and intermediate trophoblastic tumor.

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“…These patients received fewer courses of chemotherapy than patients without surgery. 14 Gestational trophoblastic neoplasia not otherwise specified surgical patients were older than the matched cohort of patients who received chemotherapy alone, likely due to preferences for fertility preservation in younger patients. Our data suggest that surgery is a viable treatment option in certain patients, because OS was no different between these groups.…”

Section: Discussionmentioning

confidence: 99%

Complete Resection Is Essential in the Surgical Treatment of Gestational Trophoblastic Neoplasia

Essel

Shafer

Bruegl

et al. 2018

Int J Gynecol Cancer

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The added value of hysterectomy in the management of gestational trophoblastic neoplasia

Cited by 30 publications

References 30 publications

Management and risk factors of recurrent gestational trophoblastic neoplasia: An update from 2004 to 2017

Management and risk factors of recurrent gestational trophoblastic neoplasia: An update from 2004 to 2017

Gestational Trophoblastic Neoplasia, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology

Complete Resection Is Essential in the Surgical Treatment of Gestational Trophoblastic Neoplasia

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