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Diagnostik und Therapie von Trophoblasterkrankungen

Überarbeitete Leitlinie gibt Orientierung

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gynäkologie + geburtshilfe Aims and scope

Gestationsbedingte Trophoblasterkrankungen umfassen eine Reihe von gutartigen und bösartigen Krankheitsbildern, die sich vom villösen oder extravillösen Trophoblastepithel ableiten. Die aktualisierte Leitlinie, die nun als S2k-Klasse vorliegt, gibt dem behandelnden Arzt Empfehlungen zum Management dieser seltenen Erkrankungen.

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Literatur

  1. Akbulut M, Tosun H, Soysal ME, Oztekin O. Endometrioid carcinoma of the endometrium with choriocarcinomatous differentiation: a case report and review of the literature. Arch Gynecol Obstet. 2008;278(1):79–84.

    Article  PubMed  Google Scholar 

  2. Alifrangis C, Agarwal R, Short D, Fisher RA, Sebire NJ, Harvey R, Savage PM, Seckl MJ. EMA/CO for high-risk gestational trophoblastic neoplasia: good outcomes with induction low-dose etoposide-cisplatin and genetic analysis. J Clin Oncol. 2013 10;31(2):280–6.

    Article  CAS  PubMed  Google Scholar 

  3. Baergen RN, Rutgers JL. Trophoblastic lesions of the placental site. Gen Diagn Pathol. 1997;143(2-3):143–58.

    CAS  PubMed  Google Scholar 

  4. Baergen RN, Rutgers JL, Young RH, Osann K, Scully RE. Placental site trophoblastic tumor: A study of 55 cases and review of the literature emphasizing factors of prognostic significance. Gynecol Oncol. 2006;100(3):511–20.

    Article  PubMed  Google Scholar 

  5. Barber EL, Schink JC, Lurain JR. Hepatic metastasis in gestational trophoblastic neoplasia: patient characteristics, prognostic factors, and outcomes. J Reprod Med. 2014;59(5-6):199–203.

    PubMed  Google Scholar 

  6. Chapman-Davis E, Hoekstra AV, Rademaker AW, Schink JC, Lurain JR. Treatment of nonmetastatic and metastatic low-risk gestational trophoblastic neoplasia: factors associated with resistance to single-agent methotrexate chemotherapy. Gynecol Oncol. 2012;125(3):572–5.

    Article  PubMed  Google Scholar 

  7. Cole LA, Sutton JM, Higgins TN, Cembrowski GS. Between-method variation in human chorionic gonadotropin test results. Clin Chem. 2004;50(5):874–82.

    Article  CAS  PubMed  Google Scholar 

  8. Davis MR, Howitt BE, Quade BJ, Crum CP, Horowitz NS, Goldstein DP, Berkowitz RS. Epithelioid trophoblastic tumor: A single institution case series at the New England Trophoblastic Disease Center. Gynecol Oncol. 2015;137(3):456–61.

    Article  CAS  PubMed  Google Scholar 

  9. Deicas RE, Miller DS, Rademaker AW, Lurain JR. The role of contraception in the development of postmolar gestational trophoblastic tumor. Obstet Gynecol. 1991;78(2):221–6.

    Google Scholar 

  10. De Miguel JR, Quintana R, González-Rodilla I, Odriozola JM, Schneider J. Exaggerated placental site/placental site trophoblastic tumor: an underestimated risk factor for emergency peripartum hysterectomy. Clin Exp Obstet Gynecol. 2014;41(6):638–40.

    PubMed  Google Scholar 

  11. Feltmate CM, Genest DR, Wise L, Bernstein MR, Goldstein DP, Berkowitz RS. Placental site trophoblastic tumor: a 17-year experience at the New England Trophoblastic Disease Center. Gynecol Oncol. 2001;82(3):415–9.

  12. Fisher RA, Nucci MR, Thaker HM, Weremowicz S, Genest DR, Castrillon DH. Complete hydatidiform mole retaining a chromosome 11 of maternal origin: molecular genetic analysis of a case. Mod Pathol. 2004;17(9):1155–60.

    Article  PubMed  Google Scholar 

  13. Flam F, Lundström V, Pettersson F. Medical induction prior to surgical evacuation of hydatidiform mole: is there a greater risk of persistent trophoblastic disease? Eur J Obstet Gynecol Reprod Biol. 1991;42(1):57–60.

    Article  CAS  PubMed  Google Scholar 

  14. Garrett LA, Garner EI, Feltmate CM, Goldstein DP, Berkowitz RS. Subsequent pregnancy outcomes in patients with molar pregnancy and persistent gestational trophoblastic neoplasia. J Reprod Med. 2008;53(7):481–6.

    PubMed  Google Scholar 

  15. Hoffner L, Surti U. The genetics of gestational trophoblastic disease: a rare complication of pregnancy. Cancer Genet. 2012;205(3):63–77.

    Article  CAS  PubMed  Google Scholar 

  16. Kumar S, Vimala N, Mittal S. Invasive Mole Presenting as Acute Haemoperitoneum. JK Science. 2004;6(3):159–60.

    Google Scholar 

  17. Lybol C, Sweep FC, Harvey R, Mitchell H, Short D, Thomas CM, Ottevanger PB, Savage PM, Massuger LF, Seckl MJ. Relapse rates after two versus three consolidation courses of methotrexate in the treatment of low-risk gestational trophoblastic neoplasia. Gynecol Oncol. 2012;125(3):576–9.

    Article  CAS  PubMed  Google Scholar 

  18. Mangili G, Lorusso D, Brown J, Pfisterer J, Massuger L, Vaughan M, Ngan HY, Golfier F, Sekharan PK, Charry RC, Poveda A, Kim JW, Xiang Y, Berkowtiz R, Seckl MJ. Trophoblastic disease review for diagnosis and management: a joint report from the International Society for the Study of Trophoblastic Disease, European Organisation for the Treatment of Trophoblastic Disease, and the Gynecologic Cancer InterGroup. Int J Gynecol Cancer. 2014;24(9 Suppl 3):S109–16.

    Article  PubMed  Google Scholar 

  19. Pezeshki M, Hancock BW, Silcocks P, Everard JE, Coleman J, Gillespie AM, Tidy J, Coleman RE. The role of repeat uterine evacuation in the management of persistent gestational trophoblastic disease. Gynecol Oncol. 2004;95(3):423–9.

    Article  CAS  PubMed  Google Scholar 

  20. Piura B..Placental site trophoblastic tumor — a challenging rare entity. Eur J Gynaecol Oncol. 2006;27(6):545–51.

    CAS  PubMed  Google Scholar 

  21. Savage P, Williams J, Wong SL, Short D, Casalboni S, Catalano K, Seckl M. The demographics of molar pregnancies in England and Wales from 2000-2009. J Reprod Med. 2010;55(7-8):341–5.

    PubMed  Google Scholar 

  22. Schmid P, Nagai Y, Agarwal R, Hancock B, Savage PM, Sebire NJ, Lindsay I, Wells M, Fisher RA, Short D, Newlands ES, Wischnewsky MB, Seckl MJ. Prognostic markers and long-term outcome of placental-site trophoblastic tumours: a retrospective observational study. Lancet. 2009;374(9683):48–55.

    Article  CAS  PubMed  Google Scholar 

  23. Seckl MJ, Sebire NJ, Fisher RA, Golfier F, Massuger L, Sessa C; ESMO Guidelines Working Group. Gestational trophoblastic disease: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013;24 Suppl 6:vi39–50.

    PubMed  Google Scholar 

  24. Shih IM, Kurman RJ. Epithelioid trophoblastic tumor: a neoplasm distinct from choriocarcinoma and placental site trophoblastic tumor simulating carcinoma. Am J Surg Pathol. 1998;22(11):1393–403.

    Article  CAS  PubMed  Google Scholar 

  25. Sun SY, Melamed A, Goldstein DP, Bernstein MR, Horowitz NS, Moron AF, Maestá I, Braga A, Berkowitz RS. Changing presentation of complete hydatidiform mole at the New England Trophoblastic Disease Center over the past three decades: Does early diagnosis alter risk for gestational trophoblastic neoplasia? Gynecol Oncol. 2015;138(1):46–9.

    Article  PubMed  Google Scholar 

  26. Taylor F, Short D, Winter MC, Tidy J, Savage PM, Sarwar N, Hancock BW, Seckl MJ, Coleman RE. A retrospective study to evaluate single agent methotrexate treatment in low risk gestational choriocarcinoma in the United Kingdom. Gynecol Oncol. 2015;136(2):258–63.

    Article  CAS  PubMed  Google Scholar 

  27. Tempfer C, Horn LC, Ackermann S et al. Gestationsbedingte und nicht gestationsbedingte Trophoblasterkrankungen. Leitlinie der DGGG (S2k-Level, AWMF-Registernummer 032/049, Dezember 2015)

  28. Tham BW, Everard JE, Tidy JA, Drew D, Hancock BW. Gestational trophoblastic disease in the Asian population of Northern England and North Wales. BJOG. 2003;110(6):555–9.

    Article  CAS  PubMed  Google Scholar 

  29. Zhang X, Lü W, Lü B. Epithelioid trophoblastic tumor: an outcome-based literature review of 78 reported cases. Int J Gynecol Cancer. 2013;23(7):1334–8.

    Article  PubMed  Google Scholar 

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Correspondence to Clemens Tempfer MBA.

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Tempfer, C. Überarbeitete Leitlinie gibt Orientierung. gynäkologie + geburtshilfe 21, 21–27 (2016). https://doi.org/10.1007/s15013-016-0899-8

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