Outcomes of metastatic gestational trophoblastic neoplasia: Fourteen year experience from a northern Thailand tertiary care center

Metastatic gestational trophoblastic neoplasia (GTN) is an uncommon cancer. The principal treatment consists of chemotherapy with or without surgery or radiotherapy. We here retrospectively reviewed the outcomes of metastatic GTN treated at our institute between January, 1999 and December, 2013. Six...

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Main Authors: Prapaporn Suprasert, Sitthicha Siriaree, Manatsawee Manopunya
Format: Journal
Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/55217
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spelling th-cmuir.6653943832-552172018-09-05T03:09:52Z Outcomes of metastatic gestational trophoblastic neoplasia: Fourteen year experience from a northern Thailand tertiary care center Prapaporn Suprasert Sitthicha Siriaree Manatsawee Manopunya Biochemistry, Genetics and Molecular Biology Medicine Metastatic gestational trophoblastic neoplasia (GTN) is an uncommon cancer. The principal treatment consists of chemotherapy with or without surgery or radiotherapy. We here retrospectively reviewed the outcomes of metastatic GTN treated at our institute between January, 1999 and December, 2013. Sixty-three patients met the criteria. The median age was 30.0 years and almost 90% were referral cases. Nearly 40% of the studied patients presented with vaginal bleeding while 22.2% were asymptomatic. The most common antecedent pregnancy was hydatidiform mole (57.1%) followed by term pregnancy (20.6%). The median interval time from antecedent pregnancy to the development of GTN was three months and the median pretreatment B-hCG was 58,274 mIU/ml. Stage III (74.6%) was the most common staging followed by stage IV (20.6%) and stage II (4.8%). The most frequent surgery was hysterectomy (31.7%). Thoracotomy and craniotomy were performed in three and two patients, respectively. The most common first line chemotherapy regimen was methotrexate and folinic acid (36.5%) followed by EMA (etoposide, methotrexate, actinomycin D) (34.9%), EMACO (etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine) (17.5%) with the remission rate of 66.7%. Nearly one-third of the patients were given a subsequent chemotherapy regimen after failure with the first line therapy and showed a final response rate of 73.0%. However, in stage IV, the response to first line treatment was only 38.5%. In conclusion, the outcomes of metastatic GTN were poor especially with the higher stages. 2018-09-05T02:53:13Z 2018-09-05T02:53:13Z 2016-04-19 Journal 15137368 2-s2.0-84965064288 10.7314/APJCP.2016.17.3.1357 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84965064288&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/55217
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Biochemistry, Genetics and Molecular Biology
Medicine
spellingShingle Biochemistry, Genetics and Molecular Biology
Medicine
Prapaporn Suprasert
Sitthicha Siriaree
Manatsawee Manopunya
Outcomes of metastatic gestational trophoblastic neoplasia: Fourteen year experience from a northern Thailand tertiary care center
description Metastatic gestational trophoblastic neoplasia (GTN) is an uncommon cancer. The principal treatment consists of chemotherapy with or without surgery or radiotherapy. We here retrospectively reviewed the outcomes of metastatic GTN treated at our institute between January, 1999 and December, 2013. Sixty-three patients met the criteria. The median age was 30.0 years and almost 90% were referral cases. Nearly 40% of the studied patients presented with vaginal bleeding while 22.2% were asymptomatic. The most common antecedent pregnancy was hydatidiform mole (57.1%) followed by term pregnancy (20.6%). The median interval time from antecedent pregnancy to the development of GTN was three months and the median pretreatment B-hCG was 58,274 mIU/ml. Stage III (74.6%) was the most common staging followed by stage IV (20.6%) and stage II (4.8%). The most frequent surgery was hysterectomy (31.7%). Thoracotomy and craniotomy were performed in three and two patients, respectively. The most common first line chemotherapy regimen was methotrexate and folinic acid (36.5%) followed by EMA (etoposide, methotrexate, actinomycin D) (34.9%), EMACO (etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine) (17.5%) with the remission rate of 66.7%. Nearly one-third of the patients were given a subsequent chemotherapy regimen after failure with the first line therapy and showed a final response rate of 73.0%. However, in stage IV, the response to first line treatment was only 38.5%. In conclusion, the outcomes of metastatic GTN were poor especially with the higher stages.
format Journal
author Prapaporn Suprasert
Sitthicha Siriaree
Manatsawee Manopunya
author_facet Prapaporn Suprasert
Sitthicha Siriaree
Manatsawee Manopunya
author_sort Prapaporn Suprasert
title Outcomes of metastatic gestational trophoblastic neoplasia: Fourteen year experience from a northern Thailand tertiary care center
title_short Outcomes of metastatic gestational trophoblastic neoplasia: Fourteen year experience from a northern Thailand tertiary care center
title_full Outcomes of metastatic gestational trophoblastic neoplasia: Fourteen year experience from a northern Thailand tertiary care center
title_fullStr Outcomes of metastatic gestational trophoblastic neoplasia: Fourteen year experience from a northern Thailand tertiary care center
title_full_unstemmed Outcomes of metastatic gestational trophoblastic neoplasia: Fourteen year experience from a northern Thailand tertiary care center
title_sort outcomes of metastatic gestational trophoblastic neoplasia: fourteen year experience from a northern thailand tertiary care center
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84965064288&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/55217
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