Pelvic arteriography in invasive trophoblastic neoplasia

Brewis, R. A. L.; Bagshawe, K. D.

doi:10.1259/0007-1285-41-487-481

Cited by 31 publications

(10 citation statements)

References 8 publications

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“…However, a subsequent study has shown that real-time ultrasound is not of use in predicting those patients who will relapse after first line chemotherapy (Long et al, 1990a). Studies using arteriographic techniques have demonstrated an abnormal uterine circulation in patients with invasive mole and choriocarcinoma (Borrell & Fernstom, 1958;Brewis & Bagshawe, 1968) but this did not aid clinical management. The development of Doppler ultrasound enables a non-invasive assessment of haemodynamics (Gosling, 1976;Skidmore & Woodcock, 1980) and is potentially superior to angiography as it reveals information about the physiological state of the circulation of an organ.…”

Section: Discussionmentioning

confidence: 99%

Doppler assessment of the uterine circulation and the clinical behaviour of gestational trophoblastic tumours requiring chemotherapy

Long

Boultbee²,

Langley³

et al. 1992

Br J Cancer

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SummaryThe haemodynamics of the uterine arteries and myometrium were assessed using Doppler ultrasound in forty consecutive patients requiring treatment for invasive mole and choriocarcinoma. The investigations were performed prior to the commencement of chemotherapy and the subjects followed prospectively. The Doppler waveforms from the uterine arteries were analysed using the pulsatility index. It was found that patients with a pulsatility index of 1.1 or less were significantly more likely to develop drug resistance than those with a higher value (P <0.04). There was no significant association between the pulsatility index and metastatic disease or uterine bleeding. Five out of eight patients who developed drug resistance could have avoided initial inadequate treatment if the Doppler findings were included in the scoring system for selecting chemotherapy for these tumours. It can be concluded that assessment of the uterine arteries using the pulsatility index prior to the treatment of patients with invasive mole and choriocarcinoma is of help in predicting those who will develop drug resistance.

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Section: Discussionmentioning

confidence: 99%

Doppler assessment of the uterine circulation and the clinical behaviour of gestational trophoblastic tumours requiring chemotherapy

Long

Boultbee²,

Langley³

et al. 1992

Br J Cancer

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“…Borell et al [5] in 1955 ob served 3 cases of trophoblastic disease and reported that pelvic angiography might be of value in diagnosis and follow-up. Several in vestigators reported that pelvic angiography is an easy, safe and valuable diagnostic pro cedure and described the characteristic an giographic findings of malignant trophoblas tic disease [6][7][8][9][10][11], These findings included prominent uterine arteries, hypervascularity of the uterus, arteriovenous shunts, tumor staining, pooling and translucency.…”

Section: Discussionmentioning

confidence: 99%

“…It is very important to differentiate choriocarcinoma from invasive mole, without the necessity of a hysterecto my. Brewis and Bagshawe [6] stated that there was no reliable basis for distinction between choriocarcinoma following mole and invasive mole. Kolstad and Liverud [8] pointed out that the differentiation between choriocarcinoma and invasive mole is in practice of minor importance, since the treatment is the same for both lesions.…”

Section: Discussionmentioning

confidence: 99%

“…The first report of angiographic find ings of malignant trophoblastic disease was made in 1955 by Borell et al [5] and several investigators have reported that pelvic angi ography is useful in the diagnosis and follow up of trophoblastic disease and described the caracteristics of pelvic angiography in malig nant trophoblastic disease [6][7][8][9][10][11],…”

Section: Introductionmentioning

confidence: 99%

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Pelvic Angiography in Malignant Trophoblastic Disease

Hata¹,

Sasaki²,

Nakano³

1987

Gynecol Obstet Invest

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Pelvic angiography was analyzed in 24 patients with malignant trophoblastic disease. Abnormal findings such as prominent uterine arteries, hypervascularity of the uterus, arteriovenous shunts, tumor staining and pooling were observed. Translucency was observed in all patients with choriocarcinoma. This finding was observed in only 3 of 11 patients (27.3%) with invasive mole and was not apparent in patients with an undetermined group. These differences were statistically significant. Translucency of pelvic angiography in malignant trophoblastic disease was more suggestive of choriocarcinoma than of invasive mole. Thus, translucency in pelvic angiography may be a distinctive finding with which to differentiate choriocarcinoma from invasive mole, without resection of the uterus.

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“…We have found four other records of similar symptomatic lesions demonstrated by angiography (Bottomley and Whitehouse, 1975;Liggins, 1964;Frencken and Landman, 1965;Jeffcoate, 1975;Hibbard et al, 1972) and in two of them there had been a preceding molar pregnancy (Frencken and Landman, 1965 ;Jeffcoate, 1975). Non-symptomatic patients may show similar aneurysmal lesions after trophoblastic disease (Cockshott and Hendrickse, 1967;Brewis and Bagshawe, 1968) suggesting that molar pregnancy is a predisposing factor. All had normal HCG values and no residual tumour.…”

Section: Discussionmentioning

confidence: 99%