Advertisement

Management of Patients with Gestational Trophoblastic Neoplasia: Experience of the Southeastern Regional Center

  • Charles B. Hammond
  • Daniel L. Clarke-Pearson
  • John T. Soper
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 176)

Abstract

Gestational trophoblastic neoplasia (GTN), a group of the more virulent malignant tumors in humans, is derived from the trophoblast of human pregnancy. Prior to 1956, the prognosis for these patients was exceedingly poor, regardless of the surgical or irradiation therapies utilized (1). Since that time and the advent of systemic chemotherapy as the primary therapeutic modality for these patients, results have become exceedingly good (2). Sequential reports have been published documenting increasingly good remission rates (3–6). Cure rates now approach 100% for patients without metastases and those with “good” prognosis metastatic disease. Even in patients with “poor” prognosis GTN, high rates of remission have been achieved with vigorous multi-modality therapy.

Keywords

Hydatidiform Mole Gestational Trophoblastic Disease Trophoblastic Tumor Gestational Trophoblastic Neoplasia Invasive Mole 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Brewer, J. I., Halpern, B., and Torok, E. E., Gestational trophoblastic disease: selected clinical aspects and chorionic gonadotropin test methods, in: “Current Clinical Problems in Cancer,” R. C. Hickey, ed., Year Book Medical Publishers, Chicago (1979), p. 5.Google Scholar
  2. 2.
    Hammond, C. B., Weed, J. C., and Currie, J. L., The role of operation in current therapy of gestational trophoblastic disease, Amer. J. Obstet. Gynecol. 136: 844 (1980).Google Scholar
  3. 3.
    Li, M. D., Hertz, R., and Spencer, D. B., Effects of methotrexate upon choriocarcinoma and chorioadenoma, Proc. Soc. Exptl. Med. 93: 361 (1956).Google Scholar
  4. 4.
    Hertz, R., Lewis, J. L., Jr., and Lipsett, M. B., Five years’ experience with chemotherapy of metastatic choriocarcinoma and related trophoblastic tumors in women, Amer. J. Obstet. Gynecol. 82: 631 (1961).Google Scholar
  5. 5.
    Ross, G. T., Goldstein, D. P., Hertz, R., Lipsett, M. B., and Odell, W. D., Sequential use of methotrexate and actinomycin D in the treatment of metastatic choriocarcinoma and related trophoblastic diseases in women, Amer. J. Obstet. Gynecol. 93: 223 (1965).Google Scholar
  6. 6.
    Hammond, C. B. and Parker, R. T., Diagnosis and management of trophoblastic disease, Obstet. Gynecol. 35: 132 (1970).PubMedGoogle Scholar
  7. 7.
    Brewer, J. I., Eckman, T. R., Dolkart, R. E., Toruk, E. E., and Webster, A., Gestational trophoblastic disease - a comparative study of the results of therapy in patients with invasive mole and with choriocarcinoma, Amer. J. Obstet. Gynecol. 109: 335 (1971).Google Scholar
  8. 8.
    Bagshawe, K. D., Treatment of trophoblastic tumors, Ann. Acad. Med. 5: 273 (1976).Google Scholar
  9. 9.
    Klinefelter, H. F., Albright, F., and Griswold, G. C., Experience with a quantitative test for normal or decreased amounts of follicular stimulating hormone in the urine in endocrinological diagnosis, J. Clin. Endocrinol. 3: 529 (1943).CrossRefGoogle Scholar
  10. 10.
    Vaitukaitis, J. L., Braunstein, G. D., and Ross, G. T., A radioimmunoassay which specifically measures human chorionic gonadotropin in the presence of human luteinizing hormone, Amer. J. Obstet. Gynecol. 113: 751 (1972).Google Scholar
  11. 11.
    Goldstein, D. P., Saracco, P., Osathanondh, R., Goldstein, P. R., Mareau, A. R., and Bernstein, M. R., Methotrexate with citrovorum factor rescue for gestational trophoblastic neoplasms, Obstet. Gynecol. 51: 93 (1978).PubMedCrossRefGoogle Scholar
  12. 12.
    Miller, J. M., Jr., Surwit, E. A., and Hammond, C. B., Choriocarcinoma followign term pregnancy, Obstet. Gynecol. 53: 207 (1979).PubMedGoogle Scholar
  13. 13.
    Bagshawe, K. D. and Wilde, C. E., Infusion therapy for pelvic trophoblastic tumors, Brit. J. Obstet. Gynecol. 71: 565 (1964).CrossRefGoogle Scholar
  14. 14.
    Smith, E. B., Weed, J. C., Tyrey, L., and Hammond, C. B., Treatment of nonmetastatic trophoblastic disease: results of methotrexate alone versus methotrexate-folinic acid, Amer. J. Obstet. Gynecol. 144: 88 (1982).Google Scholar
  15. 15.
    Maroulis, G. B., Hammond, C. B., Johnsrude, I. S., Weed, J. C., Jr., and Parker, R. T., Arteriography and infusional chemotherapy in localized trophoblastic disease, Obstet. Gynecol. 45: 397 (1945).Google Scholar
  16. 16.
    Surwit, E. A., Suciu, T. N., Schmidt, H. J., and Hammond, C. B., A new combination chemotherapy for resistant trophoblastic disease, Gynecol. Oncol. 8: 110 (1979).PubMedCrossRefGoogle Scholar
  17. 17.
    Einhorn, L. H. and Donohue, J. H., Cis-diamine dichloroplatinum, vinblastine, and bleomycin. Combination chemotherapy in disseminated testicular cancer, Ann. Intern. Med. 87: 293 (1967).Google Scholar
  18. 18.
    Newlands, E. S., The activity of epipodophyllis derivative VP 216–213, and cis-platinum in combination in drug resistant choriocarcinoma. International Symposium on Gestational Trophoblastic Tumors, London, May 1979.Google Scholar
  19. 19.
    Begent, R. H. J. and Bagshawe, K. D., The management of high risk choriocarcinoma, Semin. Oncol. 9: 198 (1982).PubMedGoogle Scholar
  20. 20.
    Rothstein, G., Clarkson, D. R., Larson, W., et al., Effect of lithium on neutrophile mass and production, New Engl. J. Med. 298: 178 (1978).PubMedCrossRefGoogle Scholar
  21. 21.
    Lyman, G. H., Williams, C. C., and Preston, D., The use of lithium carbonate to reduce infection and leukopenia during systemic chemotherapy, New Engl. J. Med. 302: 257 (1980).PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1984

Authors and Affiliations

  • Charles B. Hammond
    • 1
  • Daniel L. Clarke-Pearson
    • 1
  • John T. Soper
    • 1
  1. 1.The Southeastern Regional Center for Trophoblastic Disease Department of Obstetrics and GynecologyDuke University Medical CenterDurhamUSA

Personalised recommendations