gestational trophoblastic neoplasia
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Author(s):  
Thanh Binh Han-Thi

TÓM TẮT Mục tiêu: Nhận xét một số đặc điểm lâm sàng, cận lâm sàng và kết quả hóa trị bệnh u lá nuôi thời kỳ thai nghén. Phương pháp: Nghiên cứu mô tả hồi cứu kết hợp tiến cứu. 36 bệnh nhân nữ được chẩn đoán xác định là u lá nuôi thời kỳ thai nghén từ tháng 01/2015 đến 10/2020, được phân loại thành nhóm nguy cơ thấp và cao. Nhóm nguy cơ thấp được điều trị bằng Methotrexate đơn trị. Nhóm nguy cơ cao được điều trị phác đồ EMA/CO (etoposide, methotrexate, actinomycin D/leucovorin calcium, vincristine, cyclophosphamide). Kết quả: Tuổi hay gặp nhất là > 40 tuổi. Số bệnh nhân vào viện vì ra máu âm đạo chiếm cao nhất 52,8%. Đa số bệnh nhân có Beta - HCG ban đầu < 100000 chiếm 83,3%. Thể mô bệnh học hay gặp nhất là ung thư nhau thai với 50%. Tổn thương di căn phổi chiếm cao nhất 53,8%. Tỷ lệ bệnh nhân có nguy cơ thấp và cao là như nhau chiếm 50%. Phác đồ Methotrexate đơn thuần: đáp ứng hoàn toàn là 83,3%. Phác đồ EMA/CO: tỷ lệ đáp ứng chung là 83,3%. Tỷ lệ bệnh nhân có độc tính độ 3,4 chiếm tỷ lệ nhỏ, chủ yếu trên huyết học. Kết luận: Các phác đồ cho kết quả tốt, tỷ lệ đáp ứng cao và an toàn. ABSTRACT REMARKS ON CHARACTERISTICS OF CLINICAL, SUBCLINICAL, AND RESULTS OF CHEMOTHERAPY ON GESTATIONAL TROPHOBLASTIC NEOPLASIA PATIENTS IN K HOSPITAL Objective: To remark characteristics of clinical, subclinical, and results of chemotherapy on gestational trophoblastic neoplasia patients. Methods: A retrospective combined prospective study was conducted on 36 women with low and high risks of gestational trophoblastic neoplasia from January 2015 to October 2020. The low - risk group was treated with methotrexate alone. The high - risk group was treated with EMA/CO (etoposide, methotrexate, actinomycin D/ leucovorin calcium, vincristine, cyclophosphamide). Results: The most common age was > 40 years old. Patients admitted to the hospital because of vaginal bleeding accounted for the highest rate of 52.8%. Most of the patients (83.3%) had initial Beta - HCG < 100000. The most common histopathological form is choriocarcinoma, with 50%. Lung metastatic lesions accounted for the highest (53.8%). The proportion of low - risk and high - risk patients was about 50%. The complete response rate was 83,3% with the methotrexate regimen and was 83,3% with EMA/CO regimen. The proportion of patients with grade 3.4 toxicity accounted for a small proportion, mainly in hematology. Conclusion: The regimens had good results, high response rates, and safety. Keyword: Gestational trophoblastic neoplasia, methotrexate, EMA/CO.


2022 ◽  
Vol 164 (1) ◽  
pp. 24-25
Author(s):  
Kevin Kremer ◽  
Jessica Lee ◽  
Matthew Carlson ◽  
Jayanthi Lea

2022 ◽  
Vol 21 ◽  
pp. 153303382110673
Author(s):  
Chinachote Teerapakpinyo ◽  
Wilasinee Areeruk ◽  
Patou Tantbirojn ◽  
Vorapong Phupong ◽  
Shanop Shuangshoti ◽  
...  

Objectives: The primary aim of the study was to identify miRNAs that were differentially expressed between complete hydatidiform moles (CHMs) that turned out to be gestational trophoblastic neoplasia (GTN) [GTN moles] and CHMs that regressed spontaneously after evacuation [remission moles]. The secondary aim was to study the profiles of miRNA expressions in CHMs. Methods: A case-control study was conducted on GTN moles and remission moles. We quantitatively assessed the expression of 800 human miRNAs from molar tissues using Nanostring nCounter. Results: From a pilot study, 21 miRNAs were significantly downregulated in GTN moles compared to the remission moles. Five of them (miR-566, miR-608, miR-1226-3p, miR-548ar-3p and miR-514a-3p) were downregulated for >4 folds. MiR-608 was selected as a candidate for further analysis on 18 CHMs (9 remission moles and 9 GTN moles) due to its striking association with malignant formation. MiR-608 expression was slightly lower in GTN moles compared to the remission moles, that is, 2.22 folds change [p = 0.063]. Conclusion: We identified 21 miRNAs that were differentially expressed between GTN moles and remission moles suggesting that miRNA profiles can distinguish between the two groups. Although not reaching statistically significant, miR-608 expression was slightly lower in GTN moles compared to remission moles.


2021 ◽  
Author(s):  
Li Kemin ◽  
Zhang Mengpei ◽  
Yin Rutie ◽  
Li Zhengyu

Abstract Objective To investigate efficacy and safety of monotherapy in low-risk gestational trophoblastic neoplasia (GTN) patients with a high FIGO/WHO prognostic score of 5–6. Methods The low-risk GTN patients with a high FIGO/WHO prognostic score of 5–6 from January 2012 to December 2019 were enrolled. The study is a retrospective report. Real-world data were used to analyze the efficacy and safety of single-agent chemotherapy and combination chemotherapy in patients with a high FIGO/WHO prognostic score of 5–6. Results A total of 224 patients were enrolled, including 75 cases (33.5%) with a FIGO/WHO prognostic score of 5–6. Complete remission was in all patients. Among the 29 cases with a FIGO/WHO prognostic score of 5–6 taking single-agent chemotherapy, 22 cases (75.9%) developed drug resistance, the number of chemotherapy courses was 7.8±2.1, and the number of chemotherapy courses required for β-hCG to return to normal was 5.4±1.8. Among the 46 cases taking combination chemotherapy, 7 patients (15.2%) developed drug resistance, the number of chemotherapy courses was 7.4±2.0, and the number of chemotherapy courses required for β-hCG to return to normal was 4.8±1.6. There was a statistically significant difference in the drug resistance rate between these two subgroups (P < 0.05), but there was not statistically significant difference in the total number of chemotherapy courses or number of chemotherapy courses required for β-hCG to return to normal (<2mIU/ml) (P < 0.05). Conclusion Monotherapy showed remarkable advantages in low-risk GTN patients with a FIGO/WHO prognostic score of 5–6.


2021 ◽  
pp. ijgc-2021-002797
Author(s):  
Lanzhou Jiao ◽  
Yaping Wang ◽  
Jiyong Jiang ◽  
Xiuying Wang ◽  
Wenqing Zhang ◽  
...  

ObjectiveTo assess the strategy and value of centralized surveillance of hydatidiform mole at a regional hospital in China and to investigate the necessity of prophylactic chemotherapy for high-risk complete hydatidiform mole.MethodsBetween February 2013 and February 2020, all women with hydatidiform mole in Dalian Women’s and Children’s Medical Center (Group) were registered for surveillance and treatment when indicated. Women with complete hydatidiform mole were categorized into low-risk and high-risk groups according to the criteria from Song Hongzhao’s trophoblastic neoplasia. Outcomes and treatments were analyzed retrospectively.ResultsIn total, 703 women with hydatidiform mole were registered for surveillance with a follow-up rate of 97.9% (688/703). 680 women were enrolled and 52 (7.6%) developed post-molar gestational trophoblastic neoplasia, all with low-risk International Federation of Gynecology and Obstetrics (FIGO) scores 0–5. Post-molar gestational trophoblastic neoplasia was diagnosed in 12.3% (51/413) of patients with complete hydatidiform moles and 0.4% (1/263) of patients were diagnosed with partial hydatidiform moles (χ2=32.415, p<0.001). Post-molar gestational trophoblastic neoplasia was diagnosed in 27.7% (28/101) of the high-risk complete hydatidiform mole group and in 7.4% (23/312) of the low-risk complete hydatidiform mole group (χ2=29.196, p<0.001). No difference in the pre-treatment assessments of patients with post-molar gestational trophoblastic neoplasia was found between the low-risk and high-risk complete hydatidiform mole groups (all p>0.05). All 52 patients with post-molar gestational trophoblastic neoplasia were cured, with a complete response rate of 61.2% (30/49) with first-line single-agent chemotherapy.ConclusionsA centralized hydatidiform mole surveillance program is feasible and effective and may improve the prognosis of patients with post-molar gestational trophoblastic neoplasia. Prophylactic chemotherapy is not recommended for women with high-risk complete hydatidiform mole with adequate surveillance.


F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 1115
Author(s):  
Fatma Dhieb ◽  
Miriam Boumediene ◽  
Armi Saoussem ◽  
Garci Mariem ◽  
Mathlouthi Nabil ◽  
...  

Gestational trophoblastic neoplasia refers to the aggressive subset of gestational trophoblastic disease, including invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor. These tumors may have atypical clinical presentations that can mislead the diagnosis. The reported case is a 48-year-old woman in perimenopause, without any history of vaginal bleedings nor molar pregnancy, who presented to the Emergency Department with acute abdominal pain. Serum beta human chorionic gonadotropin (β-HCG) was highly elevated at 261 675.23 mIU/ml. A complicated invasive mole was suspected, and an abdominal computed tomography was performed, showing a moderate hemoperitoneum associated to complex cystic and solid uterine mass, with a common left iliac adenomegaly and multiple pulmonary nodules. MRI showed a multiloculated cystic uterine mass with zones of hemorrhage recalling an invasive mole with perforation of the posterior uterus wall, associated to a high abundance hemoperitoneum. The diagnosis of a metastatic invasive mole complicated of uterine rupture and hemoperitoneum was retained. A surgical intervention was decided immediately and a subtotal hysterectomy with bilateral annexectomy was done. Pathologic examination of the specimen was positive for an invasive mole. The patient was proposed for chemotherapy. This case study will increase awareness of unusual clinical presentations of gestational trophoblastic neoplasia We believe that our case will contribute to the literature not only because of the rarity of this entity in perimenopausal period, but also due the atypical clinical presentation as acute abdomen without vaginal bleeding nor history of molar pregnancy evacuation


2021 ◽  
Author(s):  
L Bazzett-Matabele ◽  
B Dushimiyimana ◽  
G Uwitonze ◽  
T Sebazungu ◽  
D Ntasumbumuyange ◽  
...  

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