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Gestational trophoblastic neoplasia
Author(s) -
GHAEMMAGHAMI Fatemeh,
ASHRAFGANJOOIE Tahereh
Publication year - 2006
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/j.1743-7563.2006.00035.x
Subject(s) - medicine , chemotherapy , trophoblastic tumor , gestational trophoblastic neoplasia , placental site trophoblastic tumor , gestational trophoblastic disease , trophoblastic neoplasm , stage (stratigraphy) , radiation therapy , human chorionic gonadotropin , oncology , hysterectomy , disease , pregnancy , surgery , gestation , placenta , hormone , fetus , genetics , paleontology , biology
Gestational trophoblastic neoplasia (GTN) is one of the most curable malignancies because of the intrinsic sensitivity of the tumor to certain antineoplastic agents, effective sensitive assays for human chorionic gonadotropin (hCG), and identification of high‐risk factors that permit individualized treatment. Chemotherapy is the main modality of treatment in patients with GTN. The cure rate in patients with low‐risk GTN is 100%, and is estimated to exceed 80% in patients with high‐risk GTN. Management of GTN is based on staging (anatomical involvement staging) and scoring. Patients with persistent GTN and stage I or score ≤ 6 (low risk) should be managed with single agent chemotherapy (methotraxate or actinomycin), but patients with stage IV or score ≥ 7 (high risk) need combination chemotherapy. Gestational trophoblastic neoplasia is radiosensitive, because radiation has hemostatic and tumorocidal effect on GTN. Therefore, radiotherapy can be used in treatment of some patients with brain hepatic metastasis or in patients where chemotherapy is not possible due to medical problems. Surgery can be used in patients who are resistant to chemotherapy or in hemorrhagic cases. Surgical resection of the tumor is the main form of therapy for placental site trophoblastic tumor. This surgery consists of a hysterectomy for the majority of patients as the disease is confined to the uterus.