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. 2015 Jul;58(4):277-83.
doi: 10.5468/ogs.2015.58.4.277. Epub 2015 Jul 16.

Role of Surgical Therapy in the Management of Gestational Trophoblastic Neoplasia

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Free PMC article

Role of Surgical Therapy in the Management of Gestational Trophoblastic Neoplasia

Kyung Jin Eoh et al. Obstet Gynecol Sci. .
Free PMC article

Abstract

Objective: To evaluate the role of adjuvant surgical procedures in the management of gestational trophoblastic neoplasia (GTN).

Methods: In a retrospective review of medical records at the Severance Hospital, we identified 174 patients diagnosed with GTN between 1986 and 2006. Of the 174 patients, 129 (74%) were assigned to the nonmetastatic group, and 45 (26%) to the metastatic group; of the metastatic group patients, 6 were in the low-risk group and 39 were in the high-risk group. Thirty-two patients underwent 35 surgical procedures as part of the GTN treatment. The procedures included hysterectomy, lung resection, craniotomy, uterine wedge resection, uterine suturing for bleeding, salpingo-oophorectomy, pretherapy dilatation and curettage, adrenalectomy, nephrectomy, and uterine artery embolization.

Results: Of the 32 patients who underwent surgical procedures, 28 (87%) survived. Eleven patients underwent surgery for chemoresistant disease after receiving one or more chemotherapy regimens. Twelve patients underwent procedures to control tumor hemorrhage. Nine (81%) of 11 patients with chemoresistant disease survived, and 8 patients who underwent salvage surgery for chemoresistant disease received further chemotherapy. Of 21 patients who underwent hysterectomy, 19 (90%) achieved remission. All of three patients who had resistant foci of choriocarcinoma in the lung achieved remission through pulmonary resection.

Conclusion: Adjuvant surgical procedures, especially hysterectomy and pulmonary resection for chemoresistant disease, as well as procedures to control hemorrhage, are pivotal in the management of GTN.

Keywords: Adjuvant surgery; Gestational trophoblastic neoplasia.

Conflict of interest statement

Conflict of interest: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. A 16-week uterus filled with complete hydatidiform moles.

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