Low-risk persistent trophoblastic disease: results of treatment


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Abstract

Purpose: The aim of this study was to investigate diagnostic peculiarities, clinical features and management outcome of patients with low risk persistent gestational trophoblastic disease (PTD). Any study on this theme hasn’t taken place in Russia.Materials and methods: Between 1996 and 2012, 127 women with PTD were commenced at N.N.Blokhin ROSC. If patients developed MTX resistance or toxicity, treatment was altered according to the score system. If the risk of resistance was up to 6 points, patients received dactinomycin; if greater than 6 points, patients received EMA/CO.Results: β-hCG values normalized in 109 (85,8%) of 127 patients with MTX alone, whereas 18 (14,2%) of 127 patients required a change in treatment, because of MTX resistance. 16 patients changed to dactinomycin, of whom 14 achieved normal β-hCG values, and 2 required third-line chemotherapy with EMA/CO. β-hCG values normalized in 2 of 2 patients who changed directly to EMA/CO from MTX. Overall survival was 100% and the relapse rate was 1,6%.Conclusion: In the case of regular follow-up after hydatidiform mole (HM) evacuation, early identification and adequate treatment of PTD the cure rates approach 100%.

About the authors

M N Tikhonovskaya

ФГБУ Российский онкологический научный центр им. Н.Н.Блохина РАМН

Email: rommary03@mail.ru
акад. аспирант отд-ния гинекологии

L A Meshcheryakova

ФГБУ Российский онкологический научный центр им. Н.Н.Блохина РАМН

д-р мед. наук, вед. науч. сотр. отд-ния гинекологии

V V Kuznetcov

ФГБУ Российский онкологический научный центр им. Н.Н.Блохина РАМН

д-р мед. наук, проф., зав. отд-нием гинекологии

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