دورية أكاديمية
Complete Resection Is Essential in the Surgical Treatment of Gestational Trophoblastic Neoplasia.
| العنوان: | Complete Resection Is Essential in the Surgical Treatment of Gestational Trophoblastic Neoplasia. |
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| المؤلفون: | Essel KG; Department of Obstetrics and Gynecology, The University of Oklahoma, Oklahoma City, OK., Shafer A; Department of Gynecologic Oncology and Reproductive Sciences, The University of Texas M.D. Anderson Cancer Center, Houston, TX., Bruegl A; Department of Obstetrics and Gynecology, Oregon Health Sciences University, Portland, OR., Gershenson DM; Department of Gynecologic Oncology and Reproductive Sciences, The University of Texas M.D. Anderson Cancer Center, Houston, TX., Drury LK; Division of Gynecologic Oncology, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC., Ramondetta LM; Department of Gynecologic Oncology and Reproductive Sciences, The University of Texas M.D. Anderson Cancer Center, Houston, TX., Naumann RW; Division of Gynecologic Oncology, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC., Brown J; Division of Gynecologic Oncology, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC. |
| المصدر: | International journal of gynecological cancer : official journal of the International Gynecological Cancer Society [Int J Gynecol Cancer] 2018 Oct; Vol. 28 (8), pp. 1453-1460. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BMJ Country of Publication: England NLM ID: 9111626 Publication Model: Print Cited Medium: Internet ISSN: 1525-1438 (Electronic) Linking ISSN: 1048891X NLM ISO Abbreviation: Int J Gynecol Cancer Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2019- : [London] : BMJ Original Publication: Cambridge, MA, USA : Blackwell Scientific Publications, c1991- |
| مواضيع طبية MeSH: | Gestational Trophoblastic Disease/*surgery, Adolescent ; Adult ; Chemotherapy, Adjuvant ; Cohort Studies ; Female ; Gestational Trophoblastic Disease/drug therapy ; Gestational Trophoblastic Disease/mortality ; Gestational Trophoblastic Disease/pathology ; Humans ; Kaplan-Meier Estimate ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Staging ; Pregnancy ; Progression-Free Survival ; Retrospective Studies ; Survival Rate ; Young Adult |
| مستخلص: | Objective: The aim of this study was to determine the utility of surgery in patients with gestational trophoblastic neoplasia (GTN). Materials and Methods: We performed a retrospective institutional review board-approved analysis of all patients with GTN at a single institution from 1985 to 2015 and compared all patients who underwent surgery as definitive management for their disease to a matched cohort of those who did not. Kaplan-Meier curves were used to estimate progression-free survival (PFS) and overall survival (OS). Results: Sixty-nine patients underwent a total of 94 surgeries as definitive treatment for GTN. Nineteen patients had multiple surgeries. Progression-free survival and OS were improved in patients with complete macroscopic surgical resection (n = 61) compared with patients with gross residual disease (n = 33) (median PFS 91.2 months vs 3.3 months, and median OS not reached at 108.8 months vs 66.3 months, respectively; P < 0.05). The nature of the surgery (emergent vs planned) and site of metastatic disease did not influence PFS or OS. Of the 61 patients with no visible residual disease, 17 received adjuvant chemotherapy and 44 did not; there were no observed differences in PFS or OS. Patients who underwent surgery as part of definitive treatment (n = 69 patients) were compared with patients with GTN over the same period who received chemotherapy alone (n = 33 patients). Median PFS was improved in the surgical group (5.9 vs 5.1 months, P < 0.01), but OS was not significantly different (P = 0.37). Conclusions: Complete resection results in improved outcomes in patients who undergo surgery for GTN, whether emergent or planned, independent of disease site, and should be considered as an important component of treatment in some situations. |
| تواريخ الأحداث: | Date Created: 20180830 Date Completed: 20190719 Latest Revision: 20190719 |
| رمز التحديث: | 20240829 |
| DOI: | 10.1097/IGC.0000000000001348 |
| PMID: | 30157165 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1525-1438 |
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| DOI: | 10.1097/IGC.0000000000001348 |