Role of surgical therapy in the management of gestational trophoblastic neoplasia
Obstetrics & Gynecology Science
;
: 277-283, 2015.
Article
in English
| WPRIM
| ID: wpr-213391
ABSTRACT
OBJECTIVE:
To evaluate the role of adjuvant surgical procedures in the management of gestational trophoblastic neoplasia (GTN).METHODS:
In a retrospective review of medical records at the Severance Hospital, we identified 174 patients diagnosed with GTN between 1986 and 2006. Of the 174 patients, 129 (74%) were assigned to the nonmetastatic group, and 45 (26%) to the metastatic group; of the metastatic group patients, 6 were in the low-risk group and 39 were in the high-risk group. Thirty-two patients underwent 35 surgical procedures as part of the GTN treatment. The procedures included hysterectomy, lung resection, craniotomy, uterine wedge resection, uterine suturing for bleeding, salpingo-oophorectomy, pretherapy dilatation and curettage, adrenalectomy, nephrectomy, and uterine artery embolization.RESULTS:
Of the 32 patients who underwent surgical procedures, 28 (87%) survived. Eleven patients underwent surgery for chemoresistant disease after receiving one or more chemotherapy regimens. Twelve patients underwent procedures to control tumor hemorrhage. Nine (81%) of 11 patients with chemoresistant disease survived, and 8 patients who underwent salvage surgery for chemoresistant disease received further chemotherapy. Of 21 patients who underwent hysterectomy, 19 (90%) achieved remission. All of three patients who had resistant foci of choriocarcinoma in the lung achieved remission through pulmonary resection.CONCLUSION:
Adjuvant surgical procedures, especially hysterectomy and pulmonary resection for chemoresistant disease, as well as procedures to control hemorrhage, are pivotal in the management of GTN.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Choriocarcinoma
/
Medical Records
/
Retrospective Studies
/
Adrenalectomy
/
Craniotomy
/
Gestational Trophoblastic Disease
/
Dilatation and Curettage
/
Drug Therapy
/
Uterine Artery Embolization
/
Hemorrhage
Type of study:
Observational study
/
Prognostic study
Limits:
Female
/
Humans
/
Pregnancy
Language:
English
Journal:
Obstetrics & Gynecology Science
Year:
2015
Type:
Article
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