Update on the diagnosis and management of gestational trophoblastic disease

Ngan, Hextan Y.S.; Seckl, Michael J.; Berkowitz, Ross S.; Xiang, Yang; Golfier, François; Sekharan, Paradan K.; Lurain, John R.

doi:10.1016/j.ijgo.2015.06.008

Cited by 251 publications

(423 citation statements)

References 31 publications

(35 reference statements)

Supporting

Mentioning

403

Contrasting

Unclassified

Order By: Relevance

“…Hydatidiform mole is the most common form of trophoblastic disease, and is considered a benign condition that may develop into other malignant forms, referred indistinctly as gestational trophoblastic neoplasia. 1,2 The incidence of hydatidiform mole varies in different populations, affecting 1:1,000 pregnancies in Europe and the United States, while in Asian countries the incidence may reach up to two cases in every 1,000 pregnancies. 2 In Brazil, there is no official database for gestational trophoblastic disease.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 The incidence of hydatidiform mole varies in different populations, affecting 1:1,000 pregnancies in Europe and the United States, while in Asian countries the incidence may reach up to two cases in every 1,000 pregnancies. 2 In Brazil, there is no official database for gestational trophoblastic disease. A large Brazilian epidemiological study showed the occurrence of 5,250 cases of gestational trophoblastic disease in ten reference centers over the course of 11 years, which can be translated into 477 new cases per year.…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, the partial mole originates from dispermy, with fertilization of an oocyte by two spermatozoa, producing a triploid pregnancy, with focal histological abnormalities. 1,2,4 About 15% of patients with complete moles and less than 5% of those with partial moles develop gestational trophoblastic neoplasia, therefore, the monitoring of these women is fundamental to enable early detection of post-molar disease. The persistence of raised hCG levels and abnormal ultrasound imaging after uterine evacuation leads to the diagnosis of trophoblastic neoplasia, and in some cases metastasis may also be present.…”

Section: Introductionmentioning

confidence: 99%

“…The persistence of raised hCG levels and abnormal ultrasound imaging after uterine evacuation leads to the diagnosis of trophoblastic neoplasia, and in some cases metastasis may also be present. 1,2 There is a choice between chemotherapy and/or surgery in the treatment of trophoblastic neoplasia, depending on staging, risk classification and reproductive desire. Patients with trophoblastic neoplasia are classified by the presence of risk factors according to the International Federation of Gynecology and Obstetrics' (FIGO) prognostic score (2002).…”

Section: Introductionmentioning

confidence: 99%

“…Patients with a score from 0 to 6 are classified as having low-risk disease, receiving a single chemotherapy agent, whereas those with a score of 7 or more are considered as high-risk and benefit from receiving combination chemotherapy. 2 More than 90% of patients with trophoblastic neoplasia undergo successful treatment with chemotherapy. 2 Thus, an additional concern is related to their reproductive future.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Pregnancy outcomes after chemotherapy for trophoblastic neoplasia

Garcia

Lin

Fushida

et al. 2016

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

SUMMARY Introduction The successful development of chemotherapy enabled a fertilitysparing treatment for patients with trophoblastic neoplasia. After disease remission, the outcome of a subsequent pregnancy becomes a great concern for these women. Objective To analyze existing studies in the literature that describe the reproductive outcomes of patients with trophoblastic neoplasia treated with chemotherapy. Method Systematic review was performed searching for articles on Medline/ Pubmed, Lilacs and Cochrane Library databases, using the terms “gestational trophoblastic disease” and “pregnancy outcome”. Results A total of 18 articles were included. No evidence of decreased fertility after chemotherapy for trophoblastic neoplasia was observed. The abortion rates in patients who conceived within 6 months after chemotherapy was higher compared to those who waited longer. Some studies showed increased rates of stillbirth and repeat hydatidiform moles. Only one work showed increased congenital abnormalities. Conclusion The pregnancies conceived after chemotherapy for trophoblastic neoplasia should be followed with clinical surveillance due to higher rates of some pregnancy complications. However, studies in the literature provide reassuring data about reproductive outcomes of these patients.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Pregnancy outcomes after chemotherapy for trophoblastic neoplasia

Garcia

Lin

Fushida

et al. 2016

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

show abstract

Gestational Trophoblastic Disease

Pant

Lurain

2018

The American Cancer Society's Oncology in Practice

View full text Add to dashboard Cite

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

et al. 2020

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Update on the diagnosis and management of gestational trophoblastic disease

Cited by 251 publications

References 31 publications

Pregnancy outcomes after chemotherapy for trophoblastic neoplasia

Pregnancy outcomes after chemotherapy for trophoblastic neoplasia

Gestational Trophoblastic Disease

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

Contact Info

Product

Resources

About