We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
The roles of surgery and EMA/CO chemotherapy regimen in primary refractory and non-refractory gestational trophoblastic neoplasia.
- Authors
Aydiner, Adnan; Keskin, Serkan; Berkman, Sinan; Bengisu, Ergin; İlhan, Huseyin; Tas, Faruk; Topuz, Erkan
- Abstract
Purpose: To determine the characteristics and outcome of patients with refractory gestational trophoblastic neoplasia (GTN) after primary chemotherapy (CTx). Methods: The outcome of low- and high-risk patients with refractory GTN ( n = 14, 37%) was compared to those with non-refractory GTN ( n = 24, 63%). Methotrexate treatment was used for patients with low-risk disease and EMA/CO for patients with high-risk disease. Results: Median follow-up time was 53 months (range 1-173 months). All non-refractory patients and 11 refractory patients (79%) survived ( p = 0.015). Factors related to resistance to primary CTx was age ( p = 0.012), duration between causal pregnancy and initial treatment ( p = 0.003), surgery ( p = 0.014), hCG level before CTx ( p = 0.09) and half-life of hCG ( p = 0.061). Six out of 10 low-risk refractory patients treated with EMA/CO regimen in the second-line setting had been followed by no evidence of disease. Nine of 38 (24%) patients underwent surgery (TAH ± BSO) for GTN. All of the patients treated with surgery were in the non-refractory group, but none of refractory patients underwent surgery ( p = 0.014). Conclusions: Surgery and EMA/CO regimen are one of the main factors that play a role in the management of refractory low-risk GTN.
- Subjects
HEALTH outcome assessment; TROPHOBLASTIC tumors; METHOTREXATE; CANCER chemotherapy; ONCOLOGIC surgery; PREGNANCY; CHORIONIC gonadotropins
- Publication
Journal of Cancer Research & Clinical Oncology, 2012, Vol 138, Issue 6, p971
- ISSN
0171-5216
- Publication type
Article
- DOI
10.1007/s00432-012-1173-7