Management and Predictors of Treatment Failure in Patients with Chemo-Resistant/Relapsed Gestational Trophoblastic Neoplasia with Lung Metastasis.
Management and Predictors of Treatment Failure in Patients with Chemo-Resistant/Relapsed Gestational Trophoblastic Neoplasia with Lung Metastasis.
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DOI：
10.3390/jcm11247270
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发表时间：
2022-12-07
影响因子：
3.9
通讯作者：
中科院分区：
文献类型：
--
作者：
该研究的目的是评估挽救性化疗和肺切除术联合治疗化疗耐药/复发的妊娠滋养细胞瘤（GTN）伴肺转移的有效性，并确定治疗失败的预测因素。回顾性分析化疗耐药/复发GTN伴肺转移患者行补救性化疗联合肺切除术的资料。在纳入的134例患者中，术前化疗方案的数量为2-8个（中位数，3个），疗程为4-37个（中位数，14个）。分别有84例、5例、35例和10例患者行肺叶切除术、肺节段切除术、肺楔切除术和肺叶切除术加肺楔切除术。治疗结束后，130例（97.0%）患者完全缓解。在整个队列中，5年总生存率为87.6%。III期和IV期疾病队列的总生存率相似（89.4% vs. 75.0%, p = 0.137）。术前β-人绒毛膜促性腺激素（β-hCG）水平>0 IU/L （p = 0.027）和术前化疗方案数> 3 （p = 0.018）是治疗失败的预测因子。挽救性化疗加肺切除联合治疗对化疗耐药/复发GTN伴肺转移患者有效，改善预后。术前血清β-hCG >0 IU/L的患者和术前>3化疗方案的患者可能无法从这种多学科治疗中获益。
The aim of the study was to assess the effectiveness of a combined treatment modality of salvage chemotherapy and pulmonary resection in chemo-resistant/relapsed gestational trophoblastic neoplasia (GTN) with lung metastasis and identify predictors of treatment failure. Data of patients with chemo-resistant/relapsed GTN with lung metastasis who received salvage chemotherapy combined with pulmonary resection were retrospectively analyzed. Among 134 included patients, the number of preoperative chemotherapy regimens ranged from 2–8 (median, 3), and courses ranged from 4–37 (median, 14). Pulmonary lobectomies, segmentectomies, wedge resections, and lobectomies plus wedge resections were performed in 84, 5, 35, and 10 patients, respectively. After completion of treatment, 130 (97.0%) patients achieved complete remission. In the entire cohort, the 5-year overall survival (OS) rate was 87.6%. OS rates were similar between stage III and stage IV disease cohorts (89.4% vs. 75.0%, p = 0.137). Preoperative β-human chorionic gonadotropin (β-hCG) levels > 10 IU/L (p = 0.027) and number of preoperative chemotherapy regimens > 3 (p = 0.018) were predictors of treatment failure. The combined treatment modality of salvage chemotherapy and pulmonary resection is effective in patients with chemo-resistant/relapsed GTN with lung metastasis, improving their prognoses. Patients with preoperative serum β-hCG >10 IU/L and those with >3 chemotherapy regimens preoperatively may not benefit from this multidisciplinary treatment.
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目前关于妊娠滋养细胞肿瘤（GTN）免疫疗法的证据。
影响因子：
5.2
作者：
通讯作者：
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DOI：
10.1002/ijgo.13877
发表时间：
2021-10
期刊：
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
影响因子：
--
作者：
通讯作者：
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DOI：
10.1016/j.bpobgyn.2021.01.005
发表时间：
2021-07-13
影响因子：
5.5
作者：
Braga, Antonio;Elias, Kevin M.;Berkowitz, Ross S.
通讯作者：
Berkowitz, Ross S.
影响因子：
--
作者：
Eoh, Kyung Jin;Chung, Young Shin;Kim, Young Tae
通讯作者：
Kim, Young Tae
影响因子：
8.8
作者：
Powles, T.;Savage, P. M.;Stebbing, J.;Short, D.;Young, A.;Bower, M.;Pappin, C.;Schmid, P.;Seckl, M. J.
通讯作者：
Seckl, M. J.