Clinical Analysis Of 159 Hospitalized Cases Of Gestational Trophoblastic Neoplasm

Objective: To explore the clinical characteristics,diagnosis,treatment,and prognosis of gestational trophoblastic neoplasm (GTN).Methods : The treatments and curative efects of 159 GTN patients admitted to The First Affiliated Hospital,Guangxi Medical University from 2003 to 2009 were analyzed retrospectively. Prognostic risk factors of recurrent GTN were statistically analyzed.Results : (1)The complete remission rates were 76.1%(121/159) in all patients,75.2%(94/125) in patients receiving chemotherapy only,and 79.4%(27/34) in patients receiving chemotherapy combined with surgery;(2)According to FIGO staging,the complete remission rates were 75.9%(63/83) in patients with stage I GTN,50.0%(5/10)in those with StageⅡGTN,61.0%(36/59)in those with stageⅢGTN,and 57.1%(4/7) in those with stage IV GTN;(3)All patients were followed up,121 of them got complete remission(CR).Among these CR patients,13 suffered relapsed and three of the 13 patients sufered relapsed repeatedly (two times) . The re-recurrence rate was 25.0%.Thirteen patients sufered 23.3 months(6—84 months)after the cessation of treatment with an overall recurrence rate of 10.7% (13/121) :7.7% patients sufered relapsed in 6 months ;30.8% patients sufered relapsed in 12 months ; 61.5% patients sufered relapsed in 18 months ; 69.2% patients sufered relapsed in 24 months ;30.8% patients sufered relapsed after 24 months ;(4)The major adverse prognostic risk factors included: history of hydatidiform mole , overall courses of treatment received;(5)91.7% patients with recurrence got cured after receiving chemotherapy combined with surgery.Conclusion: GTN should be diagnosed and treated as early as possible.Satisfactory efects can be achieved with a combination therapy of chemotherapy and surgery.More attention should be giyen to those GTN patients with adverse prognostic risk factors.Multi—drug and multiple route chemotherapy and/or combined surgical intervention can be used to improve the cure rate and lower the re-recurence rate of the GTN recurent patients.