Can the FIGO 2000 scoring system for gestational trophoblastic neoplasia be simplified? A new retrospective analysis from a nationwide dataset

Eysbouts, Y.K.; Ottevanger, Petronella B.; Massuger, Leon F.A.G.; IntHout, Joanna; Short, Dee; Harvey, Richard A.; Kaur, Baljeet; Sebire, Neil J.; Sarwar, Naveed; Sweep, Fred C.G.J.; Seckl, Michael J.

doi:10.1093/annonc/mdx211

Cited by 28 publications

(16 citation statements)

References 23 publications

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“…Stratification of patients of lowor high-risk GTN for single-agent chemotherapy (with MTX-LV or ACT) or multi-agents chemotherapy, respectively, is based on the assessment of the CXH and FIGO indexes. However, this evaluation does not take into account the effect of MTX resistance on the effectiveness of therapy, which is very important especially in the case of low-risk GTN patients indicated for MTX-LV therapy [291,292]. The authors' findings showed that the UAPI index can be a non-invasive marker of tumour vascularity and MTX resistance, and a useful tool for the indication of appropriate chemotherapy.…”

Section: Methotrexate-based Therapy Of Gestational Trophoblastic Diseasementioning

confidence: 99%

Overview of Dual-Acting Drug Methotrexate in Different Neurological Diseases, Autoimmune Pathologies and Cancers

Koźmiński

Halik

Chesori

et al. 2020

IJMS

222

120

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Methotrexate, a structural analogue of folic acid, is one of the most effective and extensively used drugs for treating many kinds of cancer or severe and resistant forms of autoimmune diseases. In this paper, we take an overview of the present state of knowledge with regards to complex mechanisms of methotrexate action and its applications as immunosuppressive drug or chemotherapeutic agent in oncological combination therapy. In addition, the issue of the potential benefits of methotrexate in the development of neurological disorders in Alzheimer’s disease or myasthenia gravis will be discussed.

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Section: Methotrexate-based Therapy Of Gestational Trophoblastic Diseasementioning

confidence: 99%

Overview of Dual-Acting Drug Methotrexate in Different Neurological Diseases, Autoimmune Pathologies and Cancers

Koźmiński

Halik

Chesori

et al. 2020

IJMS

222

120

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“…Patients with high risk disease had 0% chance to be cured with a single-agent chemotherapy. One recent study re-evaluated all prognostic risk factors involved in the FIGO scoring system in 813 patients with GTN and proposed a simplified alternative using only five factors [6]. GTN most frequently spreads to the lung.…”

Section: Discussionmentioning

confidence: 99%

Gestational Trophoblastic Neoplasia: A Tunisian Multicenter Study

Rachdi¹,

Mokrani

Batti

et al. 2019

Asian Pac J Cancer Care

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Gestational trophoblastic disease (GTD) develops from abnormal cellular proliferation of trophoblasts following fertilization. It includes benign trophoblastic disease (hydatidiform moles (HM) and the malignant trophoblastic diseases or gestational trophoblastic neoplasia (GTN). The frequency of the GTD in Tunisia is one per 918 deliveries. The aim of this study is to analyze the clinical characteristics, treatment and outcomes of GTD at Salah Azaiez Institute (ISA). Medical records of women diagnosed with GTD at ISA from January 1, 1981 to December 31, 2012 were retrospectively reviewed. FIGO (International Federation of Gynecology and Obstetrics) score was determined retrospectively for patients treated before 2002 One hundred and nine patients with GTN were included. Patients presented with metastases at 43% of cases. The most common metastatic sites was lung (30%) and vagina (13%). 56 (51%) patients had low-risk and 21 (19%) cases had high-risk, the FIGO score was not assessed in 32 cases. After a median follow-up of 46 months, 21 patients were lost to follow-up, 12 patients died, 19 progressed and 8 relapsed. At 10 years, the OS rate was 85% and the PFS rate 79%. OS was significantly influenced by the presence of metastases at presentation (M0 100 % vs. Metastatic 62 %; p < 0.0001), FIGO stage (I-II 100% VS 61% and 65% for stage III and IV; p < 0.001), FIGO score (low-risk 99 % vs. high-risk 78 %; p < 0.001). GTN is a significant source of maternal morbidity with increased risk of mortality from complications if not detected early and treated promptly.

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“…GTD is a heterogeneous group of pregnancy-associated growths, often termed tumors, including choriocarcinoma, invasive mole, hydatidiform mole (partial and complete), epithelioid trophoblastic tumor (ETT), and placental site trophoblastic tumor (PSTT) 7– 9 , that arise from placental villous and extravillous trophoblast cells 10 . GTD has benign and malignant forms; the benign forms include partial hydatidiform moles (PHMs) and complete hydatidiform moles, whereas the malignant forms are choriocarcinoma (which can arise from hydatidiform mole, normal term pregnancy, ectopic pregnancy, or miscarriage), ETT, and PSTT 11 ( Figure 1 and Table 1).…”

Section: Gestational Trophoblastic Diseasementioning

confidence: 99%

Understanding and management of gestational trophoblastic disease

et al. 2019

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Gestational trophoblastic disease or neoplasia covers a spectrum of benign and malignant conditions arising from pregnancies with highly abnormal development of trophoblastic tissue. In this brief review, we discuss the different features of these different conditions and their origins and risk factors and introduce some of the more novel and controversial treatment options currently being explored.

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Can the FIGO 2000 scoring system for gestational trophoblastic neoplasia be simplified? A new retrospective analysis from a nationwide dataset

Abstract: Our simplified alternative using only five of the FIGO prognostic factors appears to be an accurate system for discriminating patients requiring single as opposed to multi-agent chemotherapy. Further work is urgently needed to validate these findings.

Cited by 28 publications

References 23 publications

Overview of Dual-Acting Drug Methotrexate in Different Neurological Diseases, Autoimmune Pathologies and Cancers

Overview of Dual-Acting Drug Methotrexate in Different Neurological Diseases, Autoimmune Pathologies and Cancers

Gestational Trophoblastic Neoplasia: A Tunisian Multicenter Study

Understanding and management of gestational trophoblastic disease

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