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gtn high risk survival rate

Yujia Kong, Junjun Yang, Fang Jiang, Jun Zhao, Tong Ren, Jie Li, Xiaoyu Wang, Fengzhi Feng, Xirun Wan, Yang Xiang
OBJECTIVE: The gestational trophoblastic neoplasia (GTN) patients with the International Federation of Gynecology and Obstetrics (FIGO) score≥12 are defined as ultra high-risk GTN. This study aims to investigate the clinical characteristics, the treatment efficiency, and the prognosis of ultra high-risk GTN patients. METHODS: Between January 2002 and December 2015, medical record data of 143 GTN patients with FIGO score≥12 at Peking Union Medical College Hospital (PUMCH) were reviewed...
April 28, 2017: Gynecologic Oncology
Lisanne Verhoef, David Baartz, Shona Morrison, Karen Sanday, Andrea Janet Garrett
BACKGROUND: Gestational trophoblastic neoplasia (GTN) is classified as a highly curable group of pregnancy-related malignancies; however, approximately 15% will be persistent and require chemotherapy. Up to 25% of these women will develop resistance and 2% will develop disease relapse after initial chemotherapy. Despite the need for further chemotherapy in these women, cure rates are high. OBJECTIVE: To evaluate the outcomes of women diagnosed with low-risk GTN, assessing the type of treatment, the number of chemotherapy cycles received, development of resistance or disease relapse, survival, and to assess the feasibility of changing to a new drug regimen...
March 27, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Marut Yanaranop, Chalermrat Potikul, Suphet Tuipae
BACKGROUND: Gestational trophoblastic disease (GTD) develops from abnormal cellular proliferation of trophoblasts following fertilization and is categorized as either an hydatidiform mole (HM) or a gestational trophoblastic neoplasia (GTN). OBJECTIVE: To analyze the clinical characteristics, incidence and treatment outcomes of GTD at Rajavithi Hospital. MATERIAL AND METHOD: Medical records of women diagnosed with GTD at Rajavithi Hospital from January 1, 2001 to December 31, 2010 were retrospectively reviewed...
February 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
H Al-Husaini, H Soudy, A Darwish, M Ahmed, A Eltigani, W Edesa, T Elhassan, A Omar, W Elghamry, H Al-Hashem, S Al-Hayli, I Madkhali, S Ahmad, I A Al-Badawi
PURPOSE: To report the outcomes of gestational trophoblastic neoplasia (GTN) at a single institution and to determine the factors affecting response to chemotherapy and survival. METHODS/PATIENTS: From 1979-2010, we retrospectively reviewed the data of 221 patients treated at our center. GTN Patients were assigned to low-risk (score ≤6) or high-risk (score ≥7) based on the WHO risk factor scoring system. Overall survival (OS) probabilities were estimated using Kaplan-Meier method...
May 2015: Clinical & Translational Oncology
C Even, P Pautier, P Duvillard, A Floquet, P Kerbrat, F Troalen, A Rey, C Balleyguier, Y Tazi, A Leary, P Augereau, P Morice, J-P Droz, K Fizazi, C Lhommé
BACKGROUND: Patients with high-risk gestational trophoblastic neoplasia (GTN) need multi-agent chemotherapy to be cured. The most common regimen is etoposide (E), methotrexate (M) and actinomycin D (A), alternating weekly with cyclophosphamide (C) plus vincristine (O) (EMA/CO). Cisplatin (P) is a very active drug, but it is usually restricted to second-line therapies. Herein, we report the results of a cisplatin-based therapy: APE (actinomycin D, cisplatin, and etoposide). PATIENTS AND METHODS: The efficacy and safety of APE for high-risk GTN (defined by Institut Gustave-Roussy (IGR) criteria and/or an International Federation of Gynaecology and Obstetrics (FIGO) score >6) are reported...
August 2014: European Journal of Cancer
Roshan Agarwal, Costi Alifrangis, Janet Everard, Philip M Savage, Dee Short, John Tidy, Rosemary A Fisher, Neil J Sebire, Richard Harvey, Barry W Hancock, Robert E Coleman, Michael J Seckl
OBJECTIVE: To present survival rates of high-risk gestational trophoblastic neoplasia (GTN) (FIGO score > 7) patients treated between 1995 and 2010 in the U.K. Death due to GTN is largely confined to patients with high-risk disease. In the U.K. a national system ensures that all patients are treated at only 2 specialist centers: Charing Cross Hospital (CXH) in London and Weston Park Hospital (WPH) in Sheffield. STUDY DESIGN: A total of 196 high-risk patients were identified using the CXH and WPH GTN databases, based on the risk score at the time of presentation...
January 2014: Journal of Reproductive Medicine
Shina Oranratanaphan, Ruangsak Lertkhachonsuk
BACKGROUND: Gestational trophoblastic neoplasia (GTN) is a spectrum of disease with abnormal trophoblastic proliferation. Treatment is based on FIGO stage and WHO risk factor scores. Patients whose score is 12 or more are considered as at extremely high risk with a high likelihood of resistance to first line treatment. Optimal therapy is therefore controversial. OBJECTIVE: This study was conducted in order to summarize the regimen used for extremely high risk or resistant GTN patients in our institution the in past 10 years...
2014: Asian Pacific Journal of Cancer Prevention: APJCP
Constantine Alifrangis, Roshan Agarwal, Delia Short, Rosemary A Fisher, Neil J Sebire, Richard Harvey, Philip M Savage, Michael J Seckl
PURPOSE: Patients with high-risk (International Federation of Gynecology and Obstetrics score ≥ 7) gestational trophoblastic neoplasia (GTN) frequently receive etoposide, methotrexate, and dactinomycin alternating weekly with cyclophosphamide and vincristine (EMA/CO). Between 1979 and 1995, overall survival (OS) with this regimen at our institute was 85.4% with a significant proportion of early deaths (< 4 weeks). Here, we determine whether survival rates have improved in a more recent patient cohort (1995 to 2010)...
January 10, 2013: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Shui-qin Song, Guo-nan Zhang
OBJECTIVE: To evaluate the effectiveness and safety of combination chemotherapy with bleomycin, etoposide and cisplatin (BEP) regimen on the patients with high-risk gestational trophoblastic neoplasia (GTN). METHODS: Forty-two patients with high-risk GTN admitted in Sichuan Cancer Hospital between Jan.1997 and Oct. 2011 were analyzed retrospectively. The International Federation of Gynecology and Obstetrics (FIGO) prognostic score of all patients was more than 7...
August 2012: Zhonghua Fu Chan Ke za Zhi
C Lybol, C M G Thomas, E A Blanken, F C G J Sweep, R H Verheijen, A M Westermann, I A Boere, A K L Reyners, L F A G Massuger, R Q G C M van Hoesel, P B Ottevanger
BACKGROUND: Cisplatin-based chemotherapy (etoposide 100 mg/m(2) days 1-5, methotrexate 300 mg/m(2) day 1, cyclophosphamide 600 mg/m(2) day 1, actinomycin D 0.6 mg/m(2) day 2 and cisplatin 60 mg/m(2) day 4, EMACP) was compared to EMA/CO (etoposide 100 mg/m(2) days 1-2, methotrexate 300 mg/m(2) day 1 and actinomycin D 0.5 mg i.v. bolus day 1 and 0.5 mg/m(2) day 2, alternating with cyclophosphamide 600 mg/m(2) day 8 and vincristine 1 mg/m(2) day 8) for the treatment of high-risk gestational trophoblastic neoplasia (GTN)...
March 2013: European Journal of Cancer
Jing Fu, Fang Fang, Lingxia Xie, Hengxi Chen, Fan He, Taixiang Wu, Lina Hu, Theresa A Lawrie
BACKGROUND: Hydatidiform mole (HM), also called a molar pregnancy, is characterised by an overgrowth of foetal chorionic tissue within the uterus. HMs may be partial (PM) or complete (CM) depending on their gross appearance, histopathology and karyotype. PMs usually have a triploid karyotype, derived from maternal and paternal origins, whereas CMs are diploid and have paternal origins only. Most women with HM can be cured by evacuation of retained products of conception (ERPC) and their fertility preserved...
2012: Cochrane Database of Systematic Reviews
M Stephanie Fay S Cagayan
OBJECTIVE: To describe and evaluate the clinical profile and response of patients with metastatic high-risk gestational trophoblastic neoplasia (GTN) to EMA-CO and other adjuvant treatment. STUDY DESIGN: A retrospective, descriptive analysis of data was done using charts of diagnosed cases of GTN from 2006-2010. The patients were classified according to the International Federation of Gynecology and Obstetrics anatomic staging and World Health Organization prognostic scoring...
May 2012: Journal of Reproductive Medicine
Shahila Tayib, Leon van Wijk, Lynette Denny
OBJECTIVES: The objective of the study was to describe the management of gestational trophoblastic neoplasia (GTN), with particular reference to concurrent human immunodeficiency virus (HIV) infection. METHODS: This retrospective descriptive study comprised all cases of GTN managed at Groote Schuur Hospital over a 10-year period (1999-2008). RESULTS: Seventy-six patients, with a median age of 30 years at presentation, were included in the study...
December 2011: International Journal of Gynecological Cancer
Sanju Cyriac, Rejiv Rajendranath, Veluswami Sridevi, Tenali G Sagar
OBJECTIVE: To evaluate the efficacy of etoposide, cisplatin-etoposide, methotrexate, actinomycin-D (EP-EMA) chemotherapy as the frontline treatment for gestational trophoblastic neoplasia (GTN) patients with very high (≥ 12) FIGO prognostic scores. METHODS: Nine patients with very-high-risk GTN were treated with EP-EMA at the Cancer Institute, Adyar, India, between January 1, 2001, and December 31, 2007. Salvage chemotherapy, adjuvant surgery, and radiotherapy were used when indicated...
October 2011: International Journal of Gynaecology and Obstetrics
Sanju Cyriac, Rejiv Rajendranath, Veluswami Sridevi, Tenali G Sagar
OBJECTIVE: To evaluate the efficacy and toxicity of etoposide, methotrexate, actinomycin D, cyclophosphamide and vincristine (EMA-CO) chemotherapy for the treatment of high-risk gestational trophoblastic neoplasia (GTN). STUDY DESIGN: Thirty-five patients with high-risk GTN were treated with 196 cycles of EMA-CO between 1997 and 2006. Twenty-nine patients received EMA-CO in the primary setting and another 6 after failure of single-agent chemotherapy. Salvage chemotherapy was offered to selected patients...
May 2011: Journal of Reproductive Medicine
John R Lurain
Gestational trophoblastic neoplasia (GTN) includes invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor. The overall cure rate in treating these tumors is currently >90%. Thorough evaluation and staging allow selection of appropriate therapy that maximizes chances for cure while minimizing toxicity. Nonmetastatic (stage I) and low-risk metastatic (stages II and III, score <7) GTN can be treated with single-agent chemotherapy resulting in a survival rate approaching 100%...
January 2011: American Journal of Obstetrics and Gynecology
John R Lurain, Diljeet K Singh, Julian C Schink
OBJECTIVE: To evaluate treatment of metastatic high-risk gestational trophoblastic neoplasia (GTN), including durable complete response rates to chemotherapy, factors affecting response to therapy, and overall survival. STUDY DESIGN: Forty women with metastatic high-risk GTN (International Federation of Gynecology and Obstetrics [FIGO] stages II-IV, score > or = 7) completed treatment between 1986 (when EMA-CO became the standard chemotherapy for high-risk disease) and 2009, including 26 who were treated primarily and 14 who were treated secondarily...
May 2010: Journal of Reproductive Medicine
S McGrath, D Short, R Harvey, P Schmid, P M Savage, M J Seckl
BACKGROUND: Gestational trophoblastic neoplasia (GTN) after a hydatidiform mole is either treated with single- or multi-agent chemotherapy determined by a multifactorial scoring system. Women with human chorionic gonadotrophin (hCG) levels >100 000 IU l(-1) can remain within the low-risk/single-agent category and usually choose one drug therapy. Here we compare the success and duration of single- vs multi-agent chemotherapy in this patient group. METHODS: Between 1980 and 2008, 65 women had a pre-treatment hCG >100 000 IU l(-1) and were low risk...
March 2, 2010: British Journal of Cancer
Yang Cao, Yang Xiang, Fengzhi Feng, Xirun Wan, Xiuyu Yang
The objective of this study was to evaluate the influence of surgical resection on survival outcome in patients with gestational trophoblastic neoplasia with pulmonary metastatic disease. Medical records of 62 patients with gestational trophoblastic neoplasia who underwent pulmonary lobectomy or limited resection were reviewed. The cases were divided into 3 groups, namely, the recurrent group (group A), the drug-resistant group (group B), and the group with satisfactory response to chemotherapy but with residual pulmonary lesion (group C)...
May 2009: International Journal of Gynecological Cancer
Yogesh K Vashist, Guentac Uzunoglu, Guelle Cataldegirmen, Viacheslar Kalinin, Paulus Schurr, Alexandra M Koenig, Sabrina Thieltges, Oliver Zehler, Claus Schneider, Jacob R Izbicki, Emre F Yekebas
AIMS: Gastrointestinal stromal tumours (GISTs) display genetic alterations on chromosome 22. GTn repeat (GTn) length polymorphism in the promoter of haeme oxygenase-1 gene (HMOX-1) is located on chromosome 22 and associated with malignant growth. The aim was to investigate the role of HMOX-1 promoter polymorphism in GIST patients. METHODS AND RESULTS: Tumour and corresponding healthy tissue DNA of 44 patients who underwent surgical resection of GIST were analysed by polymerase chain reaction, capillary electrophoresis and DNA sequencing...
February 2009: Histopathology
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