Gestational trophoblastic neoplasia: treatment outcomes from a single institutional experience

Alhusaini, Hamed; Soudy, Hussein; Darwish, Atef M.; Ahmed, Marwa Mostafa; Eltigani, A.; Edesa, Wael; Elhassan, Tusneem; Omar, Ayman; Elghamry, W.R.; Al-Hashem, Hashem; Madkhali, I.; Ahmad, Sarfraz; Al-Badawi, Ismail A.

doi:10.1007/s12094-014-1251-1

Cited by 20 publications

(35 citation statements)

References 15 publications

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“…Our study confirms the lower outcomes in patients with advanced-stage disease, metastatic disease and high-risk prognostic score [11][12][13][14][15][16][17].…”

Section: Discussionsupporting

confidence: 86%

“…A randomized clinical trial compared biweekly Dactinomycin versus weekly Methotrexate demonstrated a superior response rate for Dactinomycin over Methotrexate (69 vs. 53% ; p = 0.015) [9]. Retrospective reviews of patients with low-risk GTN treated with single-agent chemotherapy showed significantly higher primary remission rate with Dactinomycin than with Methotrexate regimen [10,11]. Due to decreased cost and the good tolerance of Methotrexate, especially for not inducing hair loss, Methotrexate was preferred as first line treatment.…”

Section: Discussionmentioning

confidence: 99%

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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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“…Our study confirms the lower outcomes in patients with advanced-stage disease, metastatic disease and high-risk prognostic score [11][12][13][14][15][16][17].…”

Section: Discussionsupporting

confidence: 86%

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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“…Characterized by its reliance on hematogenous dissemination for metastasis, GC generally spreads to the lungs, liver, central nervous system (CNS) and vagina . This feature is also partially responsible for the high malignancy rate and resistance to chemotherapy of GC, for which the detection of metastasis would be highly valuable for evaluating disease progression.…”

Section: Introductionmentioning

confidence: 99%

Clinical significance of circulating tumor cells in predicting disease progression and chemotherapy resistance in patients with gestational choriocarcinoma

Hou

Zhang

et al. 2018

Intl Journal of Cancer

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Gestational choriocarcinoma (GC) is a highly aggressive tumor. In our study, we systematically investigated EpCAM/CD147 expression characteristics in patients with GC and assessed the role of circulating tumor cells (CTCs) in predicting chemotherapy response and disease progression. GC tissues were positive for either epithelial cellular adhesion molecule (EpCAM) or CD147, and all samples exhibited strong human chorionic gonadotropin (HCG) expression. Among all the recruited patients (n = 115), 103 had at least 1 CTC in a 7.5-mL peripheral blood sample, and the percentage of patients with ≥4 CTCs in a particular FIGO stage group increased with a higher FIGO stage (p < 0.001). Furthermore, the pretreatment CTC count was related to tumor size (r = 0.225, p = 0.015) and the number of metastases (r = 0.603, p < 0.001). A progression analysis showed that among the 115 included patients who qualified for further examination, 52 of the 64 patients defined as progressive had ≥4 pretreatment CTCs, while only 7 of the 51 non-progressive patients had ≥4 pretreatment CTCs (p < 0.001). In multivariate analysis, CTCs (≥4) remained the strongest predictor of PFS when other prognostic markers, FIGO score and FIGO stage were included. Moreover, based on the chemotherapy response, patients with ≥4 CTCs were more likely to be resistant to chemotherapy than those with <4 CTCs (P < 0.001). These findings demonstrates the feasibility of CTC detection in cases of GC by adopting EpCAM/CD147 antibodies together as capturing antibodies. The CTC count is a promising indicator in the evaluation of biological activities and the chemotherapy response in GC patients.

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“…17,18 Our results report that the composition of antecedent pregnancy of the patients with CCA has no obvious change in the past 15 years. Most patients developed IM within 6 months after previous pregnancy, especially within 2 to 3 months.…”

Section: Discussionmentioning

confidence: 60%

Clinical Characteristics of Gestational Trophoblastic Neoplasia: A 15-Year Hospital-Based Study

Sun

Zhang

Zheng

et al. 2016

Int J Gynecol Cancer

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In the past 15 years, the incidence of GTN was still higher than in other countries from 1994 to 2009, and the mean age of patients with GTN was increased significantly, especially for the patients older than 40 years. Furthermore, patients with no clinical manifestations increased significantly, which should be paid more attention in the future works. Serum level of beta human chorionic gonadotropin and pelvic ultrasonography are still 2 important indexes for diagnosing and monitoring condition of GTN.

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Gestational trophoblastic neoplasia: treatment outcomes from a single institutional experience

Abstract: GTNs have excellent prognosis if properly treated at experienced centers. Single-agent dactinomycin seems more effective for low-risk GTN. EMA-CO remains the preferred primary treatment regimen for high-risk group. The excellent outcome reflects the success of salvage therapy.

Cited by 20 publications

References 15 publications

Gestational Trophoblastic Neoplasia: A Tunisian Multicenter Study

Gestational Trophoblastic Neoplasia: A Tunisian Multicenter Study

Clinical significance of circulating tumor cells in predicting disease progression and chemotherapy resistance in patients with gestational choriocarcinoma

Clinical Characteristics of Gestational Trophoblastic Neoplasia: A 15-Year Hospital-Based Study

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