O311 Pulmonary resection in the management of chemotherapy resistant metastatic high-risk gestational trophoblastic neoplasia: An eight-year experience at the Philippine general hospital

2009 ◽  
Vol 107 ◽  
pp. S181-S181
Author(s):  
A. Soriano-Estrella ◽  
L. Fernandez-Mondragon
Keyword(s):  
High Risk ◽  
General Hospital ◽  
Pulmonary Resection ◽  
Gestational Trophoblastic Neoplasia

Pulmonary Resection in the Management of High-Risk Gestational Trophoblastic Neoplasia

2016 ◽  
Vol 26 (4) ◽  
pp. 796-800 ◽  
Author(s):  
Margaux J. Kanis ◽  
John R. Lurain
Keyword(s):  
High Risk ◽  
Pulmonary Resection ◽  
Thoracoscopic Surgery ◽  
International Federation ◽  
Gestational Trophoblastic Neoplasia ◽  
Curative Intent ◽  
Disease Characteristics ◽  
Gynecology And Obstetrics ◽  
Risk Patients ◽  
Multiagent Chemotherapy

ObjectiveThe aim of this study was to evaluate the role of pulmonary resection in the management of high-risk gestational trophoblastic neoplasia (GTN).MethodsPatients who underwent pulmonary resection as part of their treatment for chemotherapy-resistant high-risk GTN from 1986 and 2014 were retrospectively analyzed. All patients had received 1 or more multiagent chemotherapy regimens preoperatively. Patient and disease characteristics were evaluated with respect to outcome.ResultsFifteen (26%) of 58 patients treated for high-risk GTN underwent pulmonary resection with curative intent. Mean age of patients was 29 years (range, 19–37 years). International Federation of Gynecology and Obstetrics stage was III in 12 and IV in 3. International Federation of Gynecology and Obstetrics scores ranged from 5 to 20 (mean, 10). Antecedent pregnancy was nonmolar in 11 patients (73%). Adjuvant surgical procedures other than pulmonary resection were performed in 8 patients (53%). Preoperative chemotherapy regimens ranged from 1 to 10 (median, 4) and courses numbered from 2 to 32 (median, 14). Preoperative human chorionic gonadotropin (hCG) levels ranged from 2 to 2786 mIU/mL (median, 177 mIU/mL). Pulmonary wedge resections or lobectomies were performed via video-assisted thoracoscopic surgery (11) or thoracotomy (4). Two patients underwent pulmonary resections on 2 separate occasions. No patient had complications as a result of these procedures. Eleven patients (73%) were cured. In these 11 patients, hCG levels decreased to less than 2 mIU/mL within 6 to 52 days (mean, 22 days) postoperatively.ConclusionsPulmonary resection of chemotherapy-resistant GTN was an important component of treatment in 26% of high-risk patients, 73% of whom were cured. Ideal candidates have disease isolated to the lungs and low hCG levels.

scholarly journals Gestational trophoblastic neoplasia: Retrospective analysis of clinical profile, treatment pattern and outcome

2016 ◽  
Author(s):  
Paramjeet Kaur ◽  
Ashok K. Chauhan ◽  
Anil Khurana ◽  
Yashpal Verma ◽  
Nupur Bansal
Keyword(s):  
High Risk ◽  
Risk Group ◽  
Hydatidiform Mole ◽  
Single Agent ◽  
High Risk Group ◽  
Treatment Pattern ◽  
Gestational Trophoblastic Neoplasia ◽  
Trophoblastic Tumor ◽  
Villous Trophoblast ◽  
Invasive Mole

Background: Gestational trophoblastic disease is a spectrum of cellular proliferation arising from the placental villous trophoblast. Gestational triphoblastic neoplasia (GTN) is a collective term for GTD that invade locally or metastasize. GTD includes hydatidiform mole (complete and partial) and GTN include invasive mole, choricocarcinoma, placental site trophoblastic tumor and epitheliod trophoblastic tumor. Aim: To evaluate clinicopathological profile, treatment pattern and clinical outcome in patients with gestational trophoblastic neoplasia (GTN). Materials and Methods: Twelve cases of gestational trophoblastic neoplasia treated between 2012 to November 2015 in deptt of Radiotherapy – II, PGIMS, Rohtak were evaluated in this retrospective study. Data was analyzed on the basis of age, histopathology, stage, type of treatment received and treatment related toxicities. Disease free survival was estimated. Results: Out of 12 women 7 (58 %) had hydatidiform mole, 4 (33%) invasive mole and 01 (8%) had choriocarcinoma. All the cases were given chemotherapy. Two patients had low risk disease. Among high risk group seven patients had score of less than 7 and five patients had risk score of 7 or higher. Five patients were given single agent methotrexate, seven patients received multidrug regimens. All patients are on regular follow up. One patient (high risk group) expired as she did not receive treatment. Conclusion: GTN are rare and proliferative disorders with proper diagnosis and treatment most of the cases are amenable to treatment with favorable outcome.

EMA-CO chemotherapy for high-risk gestational trophoblastic neoplasia: a clinical analysis of 54 patients

2008 ◽  
Vol 18 (2) ◽  
pp. 357-362 ◽  
Author(s):  
W.-G. Lu ◽  
F. Ye ◽  
Y.-M. Shen ◽  
Y.-F. Fu ◽  
H.-Z. Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Survival Rate ◽  
High Risk ◽  
Complete Remission ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Clinical Analysis ◽  
Secondary Malignancy ◽  
Primary Therapy ◽  
Gestational Trophoblastic Neoplasia

This study was designed to analyze the outcomes of chemotherapy for high-risk gestational trophoblastic neoplasia (GTN) with EMA-CO regimen as primary and secondary protocol in China. Fifty-four patients with high-risk GTN received 292 EMA/CO treatment cycles between 1996 and 2005. Forty-five patients were primarily treated with EMA-CO, and nine were secondarily treated after failure to other combination chemotherapy. Adjuvant surgery and radiotherapy were used in the selected patients. Response, survival and related risk factors, as well as chemotherapy complications, were retrospectively analyzed. Thirty-five of forty-five patients (77.8%) receiving EMA-CO as first-line treatment achieved complete remission, and 77.8% (7/9) as secondary treatment. The overall survival rate was 87.0% in all high-risk GTN patients, with 93.3% (42/45) as primary therapy and 55.6% (5/9) as secondary therapy. The survival rates were significantly different between two groups (χ2= 6.434, P = 0.011). Univariate analysis showed that the metastatic site and the number of metastatic organs were significant risk factors, but binomial distribution logistic regression analysis revealed that only the number of metastatic organs was an independent risk factor for the survival rate. No life-threatening toxicity and secondary malignancy were found. EMA-EP regimen was used for ten patients who were resistant to EMA-CO and three who relapsed after EMA-CO. Of those, 11 patients (84.6%) achieved complete remission. We conclude that EMA-CO regimen is an effective and safe primary therapy for high-risk GTN, but not an appropriate second-line protocol. The number of metastatic organs is an independent prognostic factor for the patient with high-risk GTN. EMA-EP regimen is a highly effective salvage therapy for those failing to EMA-CO.

scholarly journals Hubungan Antara Paritas Dan Partus Lama Dengan Kejadian Asfiksia Neonatorum Pada Bayi Baru Lahir Di Rumah Sakit Umum Daerah Kota Prabumulih Tahun 2019

2020 ◽  
Vol 5 (2) ◽  
pp. 101-106
Author(s):  
Dwi Saputri Mayang Sari
Keyword(s):  
High Risk ◽  
General Hospital ◽  
Significant Relationship ◽  
Univariate Analysis ◽  
Bivariate Analysis ◽  
P Value ◽  
Cross Sectional ◽  
Asphyxia Neonatorum ◽  
Prolonged Labor ◽  
The Relationship

Asphyxia Neonatorum is a failure to start and continue breathing spontaneously and regularly when a new baby is born or some time after birth. Babies may be born in asphyxia or may be able to breathe but then experience asphyxia some time after birth. The purpose of this study was to determine the relationship between parity and old parturition with the incidence of asphyxia neonatorum in the pre-Sumatran city general hospital in 2019. This study uses an Analytical Survey using a Cross Sectional approach. The population of this research is the babies born in the prehumulih city general hospital in 2019 amounted to 1763 people. The number of samples in this study were 326 respondents. In the univariate analysis it was found that from 326 respondents it was found that parity of high risk mothers was 168 respondents (51.5%) while parity of low risk mothers was 158 respondents (48.5%) and mothers who were diagnosed with prolonged labor were 149 respondents (45.7 %) while mothers who were not diagnosed with prolonged labor were 177 respondents (54.3%). Bivariate analysis shows parity has a significant relationship with the incidence of asphyxia neonatorum (p value 0,000) and old parturition has a significant relationship with the incidence of asphyxia neonatorum (p value 0,000). The conclusion of this study is that there is a relationship between parity and old parturition with the incidence of asphyxia neonatorum.

scholarly journals Characteristics of High-Risk Pregnancy in Sanglah General Hospital 2011-2014

2016 ◽  
Vol 5 (2) ◽  
pp. 163
Author(s):  
Ryan Saktika Mulyana ◽  
Anak Agung Ngurah Jaya Kusuma ◽  
I Nyoman Hariyasa Sanjaya ◽  
Endang Sri Widiyanti
Keyword(s):  
High Risk ◽  
General Hospital ◽  
High Risk Pregnancy ◽  
Risk Pregnancy

Fibrin Glue Administration to Support Bronchial Stump Line

2008 ◽  
Vol 16 (6) ◽  
pp. 450-453 ◽  
Author(s):  
Soner Gursoy ◽  
Murat U Yapucu ◽  
Ahmet Ucvet ◽  
Serkan Yazgan ◽  
Oktay Basok ◽  
...  
Keyword(s):  
High Risk ◽  
Fibrin Glue ◽  
Pulmonary Resection ◽  
Bronchopleural Fistula ◽  
Surgical Margin ◽  
Postoperative Mortality ◽  
Lung Abscess ◽  
Bronchial Stump ◽  
Neoadjuvant Radiotherapy ◽  
Mortality And Morbidity

Bronchopleural fistula is an important cause of mortality and morbidity after pulmonary resection. The use of fibrin glue to reduce the tension and number of sutures in the bronchial stump was assessed in this prospective study of 20 patients between June 2002 and May 2003. They all had a high risk of bronchopleural fistula development because of bronchiectasis, tuberculosis, lung abscess, diabetes mellitus, preoperative neoadjuvant radiotherapy, or residual tumor at the surgical margin. After pulmonary resection, the bronchial stump was closed with separate nonabsorbable sutures supported with fibrin glue. Bronchopleural fistula was observed in only 1 (5%) patient during 6.45 ± 3.09 months of follow-up. There was no postoperative mortality. Closing the bronchial stump with an appropriate technique and supporting it with fibrin glue were considered effective in preventing bronchopleural fistula development after pulmonary resection in high-risk patients.

Sign in / Sign up

Export Citation Format

Share Document