Mortality rate of gestational trophoblastic neoplasia with a FIGO score of ≥13

Bolze, Pierre‐Adrien; Riedl, Cécilia; Massardier, Jérôme; Lotz, Jean‐Pierre; You, Benoît; Schott, Anne-Marie; Hajri, Touria; Golfier, François

doi:10.1016/j.ajog.2015.09.083

Cited by 68 publications

(54 citation statements)

References 11 publications

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“…To avoid this, the use of initial gentle rather than full‐dose chemotherapy seems logical. Indeed, induction etoposide 100 mg/m 2 and cisplatin 20 mg/m 2 on days 1 and 2, repeated weekly for 1–3 weeks, before starting normal chemotherapy appears to have eliminated early deaths in one series with promising results now reported by others …”

Section: Treatmentmentioning

confidence: 99%

Update on the diagnosis and management of gestational trophoblastic disease

Ngan

Seckl

Berkowitz

et al. 2018

Intl J Gynecology & Obste

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Gestational trophoblastic disease (GTD) arises from abnormal placenta and is composed of a spectrum of premalignant to malignant disorders. Changes in epidemiology of GTD have been noted in various countries. In addition to histology, molecular genetic studies can help in the diagnostic pathway. Earlier detection of molar pregnancy by ultrasound has resulted in changes in clinical presentation and decreased morbidity from uterine evacuation. Follow‐up with human chorionic gonadotropin (hCG) is essential for early diagnosis of gestational trophoblastic neoplasia (GTN). The duration of hCG monitoring varies depending on histology type and regression rate. Low‐risk GTN (FIGO Stages I–III: score <7) is treated with single‐agent chemotherapy but may require additional agents; although scores 5–6 are associated with more drug resistance, overall survival approaches 100%. High‐risk GTN (FIGO Stages II–III: score >7 and Stage IV) is treated with multiple agent chemotherapy, with or without adjuvant surgery for excision of resistant foci of disease or radiotherapy for brain metastases, achieving a survival rate of approximately 90%. Gentle induction chemotherapy helps reduce early deaths in patients with extensive tumor burden, but late mortality still occurs from recurrent resistant tumors.

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Section: Treatmentmentioning

confidence: 99%

Update on the diagnosis and management of gestational trophoblastic disease

Ngan

Seckl

Berkowitz

et al. 2018

Intl J Gynecology & Obste

Self Cite

316

198

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show abstract

“…Gestational trophoblastic neoplasia is overall highly chemo sensible, and the prognosis is excellent, particularly in low-risk disease with an overall survival of almost 100%. 4 Optimizing treatment by limiting exposure to combination chemotherapy and reducing serious adverse events is currently one of the most challenging issues in treating GTN patients. Multiple single agent regimens have been reported, but methotrexate or dactinomycin is the most widely used today.…”

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confidence: 99%

Efficacy and Safety of Second-Line 5-Day Dactinomycin in Case of Methotrexate Failure for Gestational Trophoblastic Neoplasia

Prouvot

Golfier

Massardier

et al. 2018

International Journal of Gynecological Cancer

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Given a 75.7% complete response rate in methotrexate failed low-risk GTN patients treated with second-line dactinomycin and an overall survival rate of 100% after third-line treatment, the use of dactinomycin should be favored as second-line, regardless of human chorionic gonadotropin level at the time of dactinomycin initiation. However, an interval between the termination of the antecedent pregnancy and methotrexate initiation longer than 6 months should encourage considering alternative therapeutic strategies.

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“…The French reported a 5 year overall mortality rate of 2% for patients with GTN, excluding PSTT/ETT. High-risk patients with a FIGO score >12 had a mortality rate of 12% and accounted for 52% of the deaths in the entire cohort, including 6 of the 8 patients who died within four weeks of treatment initiation [9]. In a worldwide survey, Kohorn identified better survival for patients who received initial treatment at a trophoblastic disease center.…”

Section: Introductionmentioning

confidence: 99%

Fatal Gestational Trophoblastic Neoplasia

Lurain¹

2017

J Oncol Transl Res

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Mortality rate of gestational trophoblastic neoplasia with a FIGO score of ≥13

Cited by 68 publications

References 11 publications

Update on the diagnosis and management of gestational trophoblastic disease

Update on the diagnosis and management of gestational trophoblastic disease

Efficacy and Safety of Second-Line 5-Day Dactinomycin in Case of Methotrexate Failure for Gestational Trophoblastic Neoplasia

Fatal Gestational Trophoblastic Neoplasia

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