Diagnosis and treatment of high-risk metastatic gestational trophoblastic neoplasia in Hungary 40 years of experience

V. Fülöp, Iván Szigetvári, János Szepesi, György Végh, János Demeter, Ross S. Berkowitz

Research output: Contribution to journalArticle


OBJECTIVE: To review treatment results of high-risk metastatic gestational trophoblastic neoplasia (GTN) over the last 40 years in Hungary. STUDY DESIGN: Between January 1, 1977, and December 31, 2016, 197 patients were treated with high-risk metastatic GTN. Primary chemotherapy was selected based upon the patient’s stage of GTN and prognostic score. Surgery was performed mainly to either resect sites of chemotherapy-resistant disease or to treat acute complications. RESULTS: As a primary therapy, MAC was used in 124 high-risk cases and EMA-CO in 42 high-risk cases; out of those cases, 114 (91.9%) and 33 (78.6%) patients, respectively, achieved complete remission. As compared to the administration of the MAC regimen, during the last 10 years the use of EMA-CO primary combination chemotherapy had favorable outcomes and was significantly increased among our metastatic highrisk patients with more serious GTN (MAC/EMA-CO ratios between 1977–2006: 5.9 [100/17] and between 2007–2016: 0.9 [24/25]; p<0.05). Over the period of 1977–2016 54/197 (27.4%) hysterectomies were performed, while metastases were resected in 37/197 (18.8%) of high-risk patients. CONCLUSION: Patients with high-risk metastatic GTN should primarily be treated with EMA-CO com bination chemotherapy, while surgery still plays a valuable role in the disease management.

Original languageEnglish
Pages (from-to)240-248
Number of pages9
JournalJournal of Reproductive Medicine
Issue number3
Publication statusPublished - Jan 1 2018


  • Anatomical stages
  • Chemotherapy
  • Choriocarcinoma
  • Gestational trophoblastic disease
  • Gestational trophoblastic neoplasia
  • High-risk metastatic gestational trophoblastic neoplasia
  • Hysterectomy
  • Metastasis surgery
  • Prognostic score

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

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