Fertility-sparing partial hysterectomy for gestational trophoblastic neoplasia: an analysis of 36 cases

J Reprod Med. May-Jun 2014;59(5-6):274-8.

Abstract

Objective: To evaluate the success of partial hysterectomy in treating gestational trophoblastic neoplasia (GTN) and preserving fertility.

Study design: A retrospective review was conducted on 36 patients with GTN who underwent adjuvant fertility-sparing partial hysterectomy at the Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, China, between 1991 and 2008.

Results: Of 36 patients, 34 had fertility-sparing partial hysterectomy; 2 required full hysterectomy due to excessive bleeding during surgery. All women went into remission from their disease. Twenty-five subsequently achieved clinical pregnancy, resulting in a total of 23 live births.

Conclusion: Partial hysterectomy with chemotherapy can be effective in treating GTN while preserving future fertility. This should be considered as an option for women who wish to pursue pregnancy in the future.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Chemotherapy, Adjuvant
  • China
  • Chorionic Gonadotropin, beta Subunit, Human / blood
  • Cyclophosphamide / therapeutic use
  • Dactinomycin / therapeutic use
  • Etoposide / therapeutic use
  • Female
  • Fertility Preservation / methods*
  • Gestational Trophoblastic Disease / drug therapy
  • Gestational Trophoblastic Disease / surgery*
  • Humans
  • Hysterectomy / methods*
  • Methotrexate / therapeutic use
  • Pregnancy
  • Pregnancy Outcome
  • Retrospective Studies
  • Treatment Outcome
  • Vincristine / therapeutic use

Substances

  • Chorionic Gonadotropin, beta Subunit, Human
  • Dactinomycin
  • Vincristine
  • Etoposide
  • Cyclophosphamide
  • Methotrexate

Supplementary concepts

  • EMA-CO protocol
  • MAC combination