Gestational trophoblastic neoplasia, FIGO 2000 staging and classification

Ngan, Hextan Y.S.; Bender, Hans-Joachim; Benedet, J.L.; Jones, H.; Montruccoli, Giancarlo; Pecorelli, Sërgio

doi:10.1016/s0020-7292(03)90120-2

Cited by 220 publications

(188 citation statements)

References 8 publications

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“…Patients are generally asymptomatic. At the 2000 FIGO Gynecology Oncology Committee meeting the definition of postmolar GTN based on hCG-level changes, histology, and specific investigations was agreed upon (Boxes 1 and 2) [14].…”

Section: Gestational Trophoblastic Neoplasiamentioning

confidence: 99%

Update on the diagnosis and management of gestational trophoblastic disease

Ngan

Seckl

Berkowitz

et al. 2015

Intl J Gynecology & Obste

252

403

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Section: Gestational Trophoblastic Neoplasiamentioning

confidence: 99%

Update on the diagnosis and management of gestational trophoblastic disease

Ngan

Seckl

Berkowitz

et al. 2015

Intl J Gynecology & Obste

252

403

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“…However, the pregnancy was proven to be a complete hydatidiform mole and the patient underwent a hysterectomy. She was diagnosed with low-risk GTN after 3 months (WHO stage: score, I:0) (1) and received three courses of chemotherapy with methotrexate (20 mg/m 2 body surface, days [1][2][3][4][5]. The level of human chorionic gonadotropin (hCG) increased 2 years after remission of low-risk GTN and examination of a bronchoscopic biopsy of the lung pathologically confirmed choriocarcinoma.…”

Section: Case Reportmentioning

confidence: 99%

“…However, it is difficult to achieve complete remission (CR) in patients with multiple metastases or metastasis to organs other than the lungs. Multi-drug chemotherapy should be the first-line regimen for high-risk GTNs, including choriocarcinoma (1,2). Etoposide, methotrexate, actinomycin D, cyclophosphamide and vincristine (EMA/CO) (3) and methotrexate, etoposide and actinomycin D (MEA) (2) are used as first-line regimens, with an effectiveness rate of ~80%.…”

Section: Introductionmentioning

confidence: 99%

High-dose chemotherapy with autologous peripheral blood stem cell transplantation for choriocarcinoma: A case report and literature review

Yamamoto

Niimi

Fujikake

et al. 2016

Molecular and Clinical Oncology

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Abstract. Choriocarcinoma is a malignant gestational trophoblastic neoplasia (GTN) and one of the curable types of gynecological cancer. However, 10% of choriocarcinoma patients have a poor prognosis, particularly when they have metastasis, apart from pulmonary metastasis, or do not go into remission by the second chemotherapeutic regimen. We herein present the case of a 36-year-old patient who had choriocarcinoma with metastases to the lungs, liver and kidneys. The 5th and 6th regimens with cisplatin for choriocarcinoma failed and the patient developed brain metastases. She was then treated with four cycles of high-dose ifosfamide, carboplatin and etoposide (ICE) with blood progenitor cell support after confirming the effectiveness of ICE at normal doses. The serum human chorionic gonadotropin (hCG) level was 140,009 mIU/ml at the start of high-dose ICE and the patient tolerated this regimen well. However, the beneficial effect was decreasing with each successive course of treatment, with the lowest level of hCG at 103 mIU/ml after the fourth course. The patient did not achieve complete remission and succumbed to the disease 4 months after the last chemotherapy. The findings of the present case and a review of the related literature suggest that high-dose ICE with stem cell rescue may be considered as a viable treatment option for a multi-drug resistant choriocarcinoma or GTN.

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“…Проб-лема накопичення достовірних епідеміологіч-них даних може бути пов'язана з відсутністю узгодженості в описі клінічних випадків [11,12,25], некоректною характеристикою кате-горій населення, що знаходяться в групі ризи-ку, недостатньою кількістю якісно відібраних контрольних груп [4,5,20,25], а також, най-важливіше, рідкісністю даного захворювання [3]. Проблемою всіх європейських країн, у тому числі й України, є відсутність централізованих баз даних, що не дозволяє оцінити важливість цього питання та вчасно діагностувати злоякіс-ні трофобластичні пухлини, ініційовані МЗ [11].…”

Section: аналіз літературних даних та постановка завдання дослідженняunclassified

Problematic issues of diagnosis of trophoblastic disease

Педаченко

Мухомор

Аветисьян

et al. 2017

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The article investigates the difficulties of diagnosis of trophoblastic disease in practice. Till nowadays there is no general strategy in the detection and treatment of gestational trophoblastic disease, as there is no clear status. The diagnosis of this pathology is multifactorial in nature, which also presents some difficulties in the timely detection of gestational trophoblastic disease. This shown that the occurrence of this disease depends on many factors, including the important role of pathogenetic predisposition.In the current study the features of diferrential diagnosis of trophoblastic disease in the early stages of development by ultrasonography and hystologycal analysis were investigated. It was proved that these studies play an important role in the differentiation of uterine molar pregnancy. A clinical case is presented, in which disagreements in diagnoses of a pregnant patient are noted. Also there is a need to respect modern principles of medical ethics and deontology (another device, “other eye” of researcher).As the authors of the article notes, the interpretation of cases with pathology of small pregnancy terms should implemented by doctors of diagnosts together with gynecologists, who have sufficient experience and special training on the problems of trophoblastic disease. In this case, the ultrasound data in the dynamics and the results of clinical and laboratory studies should be taken into account in the complex. Histological studies should be carried out by doctors in specialized institutions (oncological centers, scientific institutions of the 4th level). This problem continues to be relevant, given the high risk of transformation of the physiological conditions of pregnancy into oncopathology, and radical decisions in such cases should be taken by the consilium.With the increase in the number of pregnant women after infertility treatment, including methods of assisted reproduction, such cases can happen more often for different reasons.Therefore doctors who are entrusted to watch and treat such patients should always take into account the significant moral, psychological and possibly additional legal aspects, the occurrence of which can often be foreseen and prevented.

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Gestational trophoblastic neoplasia, FIGO 2000 staging and classification

Cited by 220 publications

References 8 publications

Update on the diagnosis and management of gestational trophoblastic disease

Update on the diagnosis and management of gestational trophoblastic disease

High-dose chemotherapy with autologous peripheral blood stem cell transplantation for choriocarcinoma: A case report and literature review

Problematic issues of diagnosis of trophoblastic disease

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