Gestational Trophoblastic Disease Diagnosis and Treatment:An Analysis of 56 Cases

来源 :Journal of Reproduction and Contraception | 被引量 : 0次 | 上传用户:yyaizy
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Objective To investigate the diagnosis and treatment of gestational trophoblastic disease(GTD).Methods A retrospective review was conducted on 56 patients with GTD who underwent treatment in Ruijin hospital from January 2007 to December 2012. Their information of diagnosis, treatments, follow-up and efficacy were collected and analyzed Results Misdiagnosis rate was 41.1%(23/56) for the first time. Of 56 patients, 31 had direct curettage, 19 had curettage after trichosanthis(TCS) treatment, 3 had curettage after intervention treatment and 3 did not have curettage. Twenty patients with gestational trophoblastic neoplasia(GTN) took fluorouracil+vincristine+dactinomycin(VCR+KSM+5-FU) chemotherapy, but 2 of them changed to etoposide+methotrexate+actinomycetes streptozotocin-D+cyclophosphamide+vincristine(EMA-CO) chemotherapy due to drug resistance. Three patients with GTN took EMA-CO chemotherapy.Two patients with placental site trophoblastic tumor(PSTT) required surgeries, one took hysterectomy, another got mass and adnexectomy. Apart from 1 case who gave up treatment and was dead, all the other women went into remission from their diseases.Conclusion The diagnosis of trophoblastic disease rely on a comprehensive analysis.A reasonable choice of TCS or intervention can be effective and safe in treating GTD.Most patients with GTN could get complete remission by selecting the appropriate chemotherapy and surgery. Objective To investigate the diagnosis and treatment of gestational trophoblastic disease (GTD). Methods A retrospective review was conducted on 56 patients with GTD who underwent treatment in Ruijin hospital from January 2007 to December 2012. Their information of diagnosis, treatments, follow-up and efficacy were collected and analyzed Results Misdiagnosis rate was 41.1% (23/56) for the first time. Of 56 patients, 31 had direct curettage, 19 had curettage after trichosanthis (TCS) treatment, 3 had curettage after intervention treatment and 3 did not Twenty patients with gestational trophoblastic neoplasia (GTN) took fluorouracil + vincristine + dactinomycin (VCR + KSM + 5-FU) chemotherapy, but 2 of them changed to etoposide + methotrexate + actinomycetes streptozotocin-D + cyclophosphamide + vincristine (EMA- CO) chemotherapy due to drug resistance. Three patients with GTN took EMA-CO chemotherapy. Two patients with placental site trophoblastic tumor (PSTT) required surgeries, one took hystere ctomy, another got mass and adnexectomy. Apart from 1 case who gave up treatment and was dead, all the other women went into remission from their diseases.Conclusion The diagnosis of trophoblastic disease rely on a comprehensive analysis. A reasonable choice of TCS or intervention can be effective and safe in treating GTD. Patients with GTN could get complete remission by selecting the appropriate chemotherapy and surgery.
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