Sonographic characteristics of post‐molar gestational trophoblastic neoplasia at diagnosis and during follow‐up, and relationship with methotrexate resistance

2020 ◽  
Vol 56 (5) ◽  
pp. 759-765 ◽  
Author(s):  
E. Epstein ◽  
U. Joneborg
Keyword(s):  
Gestational Trophoblastic Neoplasia ◽  
Methotrexate Resistance

scholarly journals Gestational trophoblastic neoplasia: A 6 year retrospective study

2014 ◽  
Vol 03 (01) ◽  
pp. 033-037 ◽  
Author(s):  
Sushruta Shrivastava ◽  
Amal Chandra Kataki ◽  
Debabrata Barmon ◽  
Pankaj Deka ◽  
Chidananda Bhuyan ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Complete Remission ◽  
Risk Score ◽  
Single Agent ◽  
Response To Treatment ◽  
Gestational Trophoblastic Neoplasia ◽  
Response To Chemotherapy ◽  
Chemotherapy Patients ◽  
Line Chemotherapy

Abstract Aims and Objectives: To study the clinical presentations of gestational trophoblastic neoplasia and its response to chemotherapy. Materials and Methods: This is a retrospective study of 28 women of gestational trophoblastic neoplasia evaluated over a period of 6 years from January 2004 to December 2009. Patients were evaluated on the basis of their age, number of deliveries, history of abortion or molar pregnancy, and the treatment received. All patients were scored on the basis of WHO scoring system. Patients with low risk (score </=6) received single agent chemotherapy with methotrexate or actinomycin D. Patients with high risk (score >/=7) received multiple agent chemotherapy with EMACO regimen. After completion of chemotherapy patients were followed for a minimum of 2 years. The response to treatment was evaluated during follow-up by clinical examination, beta hCG levels and imaging as and when required. Results: Out of 28 women only 27 could be evaluated, because 1 patient was lost to follow-up. Out of 27 patients, 18 patients (66.67%) achieved complete remission with the first-line chemotherapy and additional 25.92% (7/27) achieved complete remission with second line chemotherapy resulting in complete remission of 92.5% (25/27). Conclusion: Gestational trophoblastic neoplasia is curable if patient is properly evaluated and scored. It shows good response to chemotherapy.

The endoglin–BMP9 axis as a predictor of methotrexate resistance in low-risk gestational trophoblastic neoplasia

2015 ◽  
Vol 136 (2) ◽  
pp. 407
Author(s):  
Kevin M. Elias ◽  
Kathleen T. Hasselblatt ◽  
Richard A. Harvey ◽  
Ross S. Berkowitz ◽  
Michael J. Seckl ◽  
...  
Keyword(s):  
Low Risk ◽  
Gestational Trophoblastic Neoplasia ◽  
Methotrexate Resistance

scholarly journals Does hormonal contraception during molar pregnancy follow-up influence the risk and clinical aggressiveness of gestational trophoblastic neoplasia after controlling for risk factors?

2017 ◽  
Vol 147 (2) ◽  
pp. 364-370 ◽  
Author(s):  
Patrícia Rangel Sobral Dantas ◽  
Izildinha Maestá ◽  
Jorge Rezende Filho ◽  
Joffre Amin Junior ◽  
Kevin M. Elias ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hormonal Contraception ◽  
Molar Pregnancy ◽  
Gestational Trophoblastic Neoplasia

scholarly journals Uterine artery pulsatility index: a predictor of methotrexate resistance in gestational trophoblastic neoplasia

2012 ◽  
Vol 106 (6) ◽  
pp. 1089-1094 ◽  
Author(s):  
R Agarwal ◽  
V Harding ◽  
D Short ◽  
R A Fisher ◽  
N J Sebire ◽  
...  
Keyword(s):  
Pulsatility Index ◽  
Uterine Artery ◽  
Gestational Trophoblastic Neoplasia ◽  
Methotrexate Resistance

Is there uniformity in definitions and treatment of gestational trophoblastic disease in Europe?

2019 ◽  
Vol 29 (1) ◽  
pp. 108-112 ◽  
Author(s):  
Minke M Frijstein ◽  
Christianne A R Lok ◽  
John Coulter ◽  
Nienke E van Trommel ◽  
Marianne J ten Kate – Booij ◽  
...  
Keyword(s):  
High Risk ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Gestational Trophoblastic Disease ◽  
Gestational Trophoblastic Neoplasia ◽  
Clinical Practices ◽  
Trophoblastic Disease ◽  
Consensus Statements ◽  
Definition Of

ObjectivesBecause gestational trophoblastic disease is rare, little evidence is available from randomized controlled trials on optimal treatment and follow-up. Treatment protocols vary within Europe, and even between different centers within countries. One of the goals of the European Organization for Treatment of Trophoblastic Diseases (EOTTD) is to harmonize treatment in Europe. To provide a basis for international standardization of definitions, treatment and follow-up protocols in gestational trophoblastic disease, we evaluated differences and similarities between protocols in EOTTD countries.MethodsMembers from each EOTTD country were asked to complete an online structured questionnaire comprising multiple-choice and multiple-answer questions. The following themes were discussed: incidence of gestational trophoblastic disease and gestational trophoblastic neoplasia, definitions, guidelines, classification system, treatment, recurrence, and follow-up.ResultsForty-four respondents from 17 countries participated in this study. Guidelines were present in 80% of the countries and the FIGO (Fédération Internationale de Gynécologie et d'Obstétrique) staging and risk classification was often used to estimate risks. Agreement about when to start chemotherapy for post-molar gestational trophoblastic neoplasia was present among 66% of the respondents. Preferred first-line treatments in low- and high-risk gestational trophoblastic neoplasia were methotrexate (81%) and EMA-CO (etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine) (93%), respectively. The definition of human chorionic gonadotropin normalization after hydatidiform mole evacuation was two consecutive normal values for nine countries. The FIGO definition of post-molar gestational trophoblastic neoplasia based on human chorionic gonadotropin plateau or rise was agreed on by 69% of respondents, and only 69% and 74% defined low-risk and high-risk disease, respectively, using FIGO criteria. There were major differences in definitions of recurrence, chemotherapy resistance and follow-up protocols among countries, despite EOTTD consensus statements.ConclusionsThis questionnaire provides a good overview of current clinical practices in different countries. Based on the survey results, it is clear that there are several gestationaltrophoblastic disease-related topics that need urgent attention within the EOTTD community to create more uniformity and to aid the development of uniform guidelines in Europe.

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