Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 51 (10), 773-6

Role of Surgery in the Management of High-Risk Gestational Trophoblastic Neoplasia

Affiliations
  • PMID: 17086805

Role of Surgery in the Management of High-Risk Gestational Trophoblastic Neoplasia

John R Lurain et al. J Reprod Med.

Abstract

Objective: To evaluate the role of surgery in the management of high-risk gestational trophoblastic neoplasia.

Study design: Twenty-four (48%) of 50 patients treated with etoposide, methotrexate, actinomycin D, cyclophosphamide and vincristine (EMA-CO) regimen as primary or secondary chemotherapy for high-risk gestational trophoblastic neoplasia between 1986 and 2005 underwent 28 adjuvant surgical procedures. The procedures included hysterectomy (17), lung resection (5), salpingectomy (1), uterine wedge resection (1), small bowel resection (1), suturing of the liver or uterus for bleeding (2) and uterine artery embolization (1).

Results: Twenty-one (87.5%) of 24 patients who had surgical procedures as part of their treatment for high-risk disease survived. Fifteen (88%) of 17 patients undergoing hysterectomy were cured. Four (80%) of 5 patients who had resistant foci of choriocarcinoma in the lung were cured by pulmonary resection. The patients who had suturing of the uterus, uterine artery embolization, small bowel resection and salpingectomy for bleeding as well as the patient who had uterine wedge resection of resistant choriocarcinoma survived.

Conclusion: Adjuvant surgical procedures, especially hysterectomy and pulmonary resection for chemotherapy-resistant disease as well as procedures to control hemorrhage, are important components in the management of high-risk gestational trophoblastic neoplasia. Twenty-four (48%) of 50 patients with high-risk gestational trophoblastic neoplasia in this series underwent surgical procedures, and 21 (87.5%) were cured.

Similar articles

See all similar articles

Cited by 13 articles

See all "Cited by" articles

Publication types

MeSH terms

Supplementary concepts

Feedback