Gestational Trophoblastic Neoplasia With Urinary System Metastasis: A Single Center Experience
Gestational Trophoblastic Neoplasia With Urinary System Metastasis: A Single Center Experience
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DOI：
10.3389/fonc.2020.01208
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发表时间：
2020-07-08
影响因子：
4.7
通讯作者：
Xiang, Yang
中科院分区：
文献类型：
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作者：
Cheng, Hongyan;Yang, Junjun;Xiang, Yang
背景：妊娠滋养细胞肿瘤合并泌尿系统转移是罕见的。关于这一情况的信息有限。本研究旨在分析GTN泌尿系统转移患者的临床特征、预后因素和生存结局。方法：回顾性分析1990年至2018年北京协和医院收治的53例GTN泌尿系统转移患者的病历。Kaplan-Meier生存分析用于描述总生存期。采用单变量和多变量分析确定预后因素。结果：53例GTN尿路转移患者在我们的机构被确定。患者的平均年龄为30.8岁（范围：23-53岁）。36例（67.9%）患者达到完全缓解（CR），其余17例（32.1%）患者显示疾病进展。整个队列的5年总生存率为78.4%。年龄≥ 40岁是影响预后的独立危险因素（HR12.353，95%CI2.203 - 69.261，P = 0.004）。既往化疗失败史（P= 0.040）和是否存在脑和/或肝转移（P= 0.024）显著影响GTN伴泌尿系统转移患者的生存。结论：GTN合并尿路转移是一种罕见的情况。不同转移部位患者的CR率和预后不同。因此，对于不同转移部位的患者，应考虑个体化策略。泌尿系统转移可能不是GTN患者的预后因素。年龄>= 40岁的患者，既往多药化疗失败的患者，以及脑和/或肝转移的患者显示出显著的不良结局。
Background:Gestational trophoblastic neoplasia (GTN) with urinary system metastasis is rare. There is limited information about this situation. This study aimed to analyze clinical features, prognostic factors, and survival outcomes of patients with metastasis to the urinary system arising from GTN. Methods:Medical records of 53 consecutive GTN patients with urinary system metastases and treated at Peking Union Medical College Hospital (PUMCH) between 1990 and 2018 were reviewed. The Kaplan-Meier survival analysis was used to describe the overall survival. Prognostic factors were identified using univariate and multivariate analyses. Results:Fifty-three GTN patients with urinary tract metastasis were identified in our institution. The mean age of patients was 30.8 years (range, 23-53 years). Thirty-six (67.9%) patients achieved complete remission (CR), and the remaining 17 (32.1%) showed progressive disease. The 5-year overall survival rate of the entire cohort was 78.4%. Age >= 40 years was an independent risk factor for prognosis (HR 12.353, 95% CI 2.203-69.261,P= 0.004). Previous failed chemotherapy history (P= 0.040) and the presence of brain and/or liver metastases (P= 0.024) significantly influenced the survival of GTN patients with urinary tract system metastasis. Conclusion:GTN with urinary tract metastasis is a rare condition. Patients with different metastatic sites have different CR rates and prognosis. Therefore, individualized strategies should be considered for patients with different metastatic sites. Urinary system metastasis is probably not a prognostic factor in GTN patients. Patients aged >= 40, those who had previous failed multidrug chemotherapy, and presented brain and/or liver metastases showed a significant adverse outcome.