Therapeutic Strategies of Ultra High-Risk Gestational Trophoblastic Neoplasms

Abstract

Abstract: Gestational trophoblastic neoplasms (GTN) is a series of malignant tumor that is extremely sensitive to chemotherapy. The main therapeutic strategies include systemic chemotherapy and the treatment of metastatic tumors. The overall survival (OS) rate almost approaches 100% in low-risk patients, whereas high-risk patients can achieve a overall survival rate of 80%～90%. Patients with the FIGO prognosis score ≥12 points or those with liver, brain metastases, or extensive metastases were defined as ultra high-risk patients. Prognosis of ultra high-risk patients has been poor, and mortality rate has been high. The main reasons include widespread chemotherapy-resistant disease, respiratory failure due to progressive disease in the lungs or hemorrhage from brain and liver metastases. The therapeutic strategies for ultra high-risk GTN patients are treated primarily with combined chemotherapy, supplemented by surgery, radiotherapy or interventional therapy. It is recommended to diagnose as soon as possible and stable patient′s condition when faced with extremely serious ultra high-risk GTN patients, also referral to the gestational trophoblastic disease centres which have a comprehensive diagnosis and treatment capability. The research progress of treatment strategies for ultra high-risk GTN was discussed in this review.

Key words: Gestational trophoblastic neoplasms, Drug therapy, Death, Neoplasm metastasis, Hemorrhage

WAN Qi-hong，QIAN Jian-hua. Therapeutic Strategies of Ultra High-Risk Gestational Trophoblastic Neoplasms[J]. Journal of International Obstetrics and Gynecology, 2018, 45(2): 216-220.

References

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