Management and prognosis of patients with liver metastases from gestational trophoblastic neoplasia: a retrospective cohort study.
Management and prognosis of patients with liver metastases from gestational trophoblastic neoplasia: a retrospective cohort study.
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妊娠滋养细胞肿瘤肝转移患者的治疗和预后：一项回顾性队列研究
DOI：
10.2147/cmar.s160606
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发表时间：
2018
影响因子：
3.3
通讯作者：
Xiang Y
中科院分区：
文献类型：
--
作者：
Zong L;Yang J;Wang X;Kong Y;Ren T;Zhao J;Feng F;Wan X;Xiang Y
目的 本研究的目的是分析妊娠滋养细胞肿瘤（GTN）肝转移患者的临床特征、确定预后因素并评估其生存结果。患者和方法从机构数据库中招募1999年1月至2015年12月期间在北京协和医院（中华人民共和国北京）接受治疗的40例GTN肝转移患者，并回顾其病历。进行单变量和多变量分析以确定生存的独立危险因素。结果 27例患者（67.5%）经多药化疗后获得完全缓解。其余 13 名患者 (32.5%) 出现疾病进展。 18 名患者（45.0%）在治疗或随访期间死亡。多种药物化疗失败史是生存的独立危险因素（OR：5.57，95% CI：1.42-21.86，P=0.014）。此外，国际妇产科联合会（FIGO）评分>16的患者的生存率明显低于评分≤16的患者（P<0.001）。结论 GTN肝转移是一种非常罕见的疾病，预后较差。有多种药物化疗失败史且FIGO评分>16的患者生存结果较差。多药化疗是GTN肝转移患者治疗的关键。
Purpose The aims of this study were to analyze the clinical features, identify prognostic factors, and evaluate the survival outcomes of gestational trophoblastic neoplasia (GTN) patients with liver metastases. Patients and methods Forty patients with liver metastases arising from GTNs, who were treated at the Peking Union Medical College Hospital (Beijing, People’s Republic of China) between January 1999 and December 2015, were recruited from the institutional database, and their medical records were reviewed. Univariate and multivariate analyses were performed to identify independent risk factors for survival. Results Twenty-seven patients (67.5%) achieved complete remission after multidrug chemotherapy treatment. The remaining 13 patients (32.5%) had disease progression. Eighteen patients (45.0%) died during treatment or follow-up. A history of failed multidrug chemotherapy was an independent risk factor for survival (OR: 5.57, 95% CI: 1.42–21.86, P=0.014). Moreover, patients with an International Federation of Gynecology and Obstetrics (FIGO) score of >16 had a significantly poorer survival than those with a score of ≤16 (P<0.001). Conclusion GTN with liver metastasis is a very rare disease with a relatively poor prognosis. Patients with a history of failed multidrug chemotherapy and a FIGO score of >16 have poorer survival outcomes. Multidrug chemotherapy is the key to the management of GTN patients with liver metastases.