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Article: Update on the diagnosis and management of gestational trophoblastic disease

TitleUpdate on the diagnosis and management of gestational trophoblastic disease
Authors
KeywordsChoriocarcinoma
Epithelioid trophoblastic tumor
FIGO Cancer Report
Gestational trophoblastic neoplasia
Moles
Placental site trophoblastic tumor
Issue Date2018
PublisherWiley for International Federation of Gynecology and Obstetrics (FIGO). The Journal's web site is located at http://obgyn.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)1879-3479/
Citation
International Journal of Gynecology & Obstetrics, 2018, v. 143 n. suppl. 2, p. 79-85 How to Cite?
AbstractGestational trophoblastic disease (GTD) arises from abnormal placenta and is composed of a spectrum of premalignant to malignant disorders. Changes in epidemiology of GTD have been noted in various countries. In addition to histology, molecular genetic studies can help in the diagnostic pathway. Earlier detection of molar pregnancy by ultrasound has resulted in changes in clinical presentation and decreased morbidity from uterine evacuation. Follow‐up with human chorionic gonadotropin (hCG) is essential for early diagnosis of gestational trophoblastic neoplasia (GTN). The duration of hCG monitoring varies depending on histology type and regression rate. Low‐risk GTN (FIGO Stages I–III: score <7) is treated with single‐agent chemotherapy but may require additional agents; although scores 5–6 are associated with more drug resistance, overall survival approaches 100%. High‐risk GTN (FIGO Stages II–III: score >7 and Stage IV) is treated with multiple agent chemotherapy, with or without adjuvant surgery for excision of resistant foci of disease or radiotherapy for brain metastases, achieving a survival rate of approximately 90%. Gentle induction chemotherapy helps reduce early deaths in patients with extensive tumor burden, but late mortality still occurs from recurrent resistant tumors.
DescriptionSpecial Issue: FIGO Cancer Report 2018
Persistent Identifierhttp://hdl.handle.net/10722/269484
ISSN
2017 Impact Factor: 2.072
2015 SCImago Journal Rankings: 1.544
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorNgan, HYS-
dc.contributor.authorSeckl, MJ-
dc.contributor.authorBerkowitz, RS-
dc.contributor.authorXiang, Y-
dc.contributor.authorGolfier, F-
dc.contributor.authorSekharan, PK-
dc.contributor.authorLurain, JR-
dc.contributor.authorMassuger, L-
dc.date.accessioned2019-04-24T08:08:39Z-
dc.date.available2019-04-24T08:08:39Z-
dc.date.issued2018-
dc.identifier.citationInternational Journal of Gynecology & Obstetrics, 2018, v. 143 n. suppl. 2, p. 79-85-
dc.identifier.issn0020-7292-
dc.identifier.urihttp://hdl.handle.net/10722/269484-
dc.descriptionSpecial Issue: FIGO Cancer Report 2018-
dc.description.abstractGestational trophoblastic disease (GTD) arises from abnormal placenta and is composed of a spectrum of premalignant to malignant disorders. Changes in epidemiology of GTD have been noted in various countries. In addition to histology, molecular genetic studies can help in the diagnostic pathway. Earlier detection of molar pregnancy by ultrasound has resulted in changes in clinical presentation and decreased morbidity from uterine evacuation. Follow‐up with human chorionic gonadotropin (hCG) is essential for early diagnosis of gestational trophoblastic neoplasia (GTN). The duration of hCG monitoring varies depending on histology type and regression rate. Low‐risk GTN (FIGO Stages I–III: score <7) is treated with single‐agent chemotherapy but may require additional agents; although scores 5–6 are associated with more drug resistance, overall survival approaches 100%. High‐risk GTN (FIGO Stages II–III: score >7 and Stage IV) is treated with multiple agent chemotherapy, with or without adjuvant surgery for excision of resistant foci of disease or radiotherapy for brain metastases, achieving a survival rate of approximately 90%. Gentle induction chemotherapy helps reduce early deaths in patients with extensive tumor burden, but late mortality still occurs from recurrent resistant tumors.-
dc.languageeng-
dc.publisherWiley for International Federation of Gynecology and Obstetrics (FIGO). The Journal's web site is located at http://obgyn.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)1879-3479/-
dc.relation.ispartofInternational Journal of Gynecology & Obstetrics-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectChoriocarcinoma-
dc.subjectEpithelioid trophoblastic tumor-
dc.subjectFIGO Cancer Report-
dc.subjectGestational trophoblastic neoplasia-
dc.subjectMoles-
dc.subjectPlacental site trophoblastic tumor-
dc.titleUpdate on the diagnosis and management of gestational trophoblastic disease-
dc.typeArticle-
dc.identifier.emailNgan, HYS: hysngan@hkucc.hku.hk-
dc.identifier.authorityNgan, HYS=rp00346-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1002/ijgo.12615-
dc.identifier.pmid30306586-
dc.identifier.scopuseid_2-s2.0-85054775711-
dc.identifier.hkuros297623-
dc.identifier.volume143-
dc.identifier.issuesuppl. 2-
dc.identifier.spage79-
dc.identifier.epage85-
dc.identifier.isiWOS:000446989500009-
dc.publisher.placeUnited Kingdom-

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