The authors review their clinical experience with the treatment of gestational trophoblastic neoplasia (GTN) over the past 25 years at the Hungarian National Trophoblastic Disease Center. Between 1st January, 1977 and 31st December, 2001 the authors treated 355 patients with GTN referred from all parts of Hungary. The patients' age varied between 14-53 years, the average being 28.3 years. The patients were selected for primary chemotherapy based upon the anatomical staging and prognostic score factors of the GTD (gestational trophoblastic disease). Out of 173 patients remission was achieved in 162 (93.2%) as a result of methotrexate therapy. In case of 11 patients (6.8%) they could obtain a complete remission by using a combination chemotherapy, in some cases assisted by operation. 5 of these 11 patients have had high-risk disease. In case of another 68 patients remission could be achieved in 63 (92.6%) as a result of Actinomycin-D therapy, whereas in 5 cases (7.4%) by a secondary combination chemotherapy. Two out of these 5 patients had a high risk disease. Chemotherapy, surgical intervention or other supplementary treatments resulted in a 100% successful therapy in cases of non-metastatic and low-risk metastatic disease in patients with GTD 95.9% curring rate (in 116 of 121 patients) was achieved in group of patients with high risk GTD using combined chemotherapy (MAC, EMA-CO, CEB) as primary treatment 98.6% total remission rate (in 350 of 355 patients) was achieved in patients with GTD at authors' center over the past 25 years. Data support the concept that patient care under the guidance of experienced clinicians serves to optimize the opportunity for cure and minimize morbidity. According to the experiences the middle-dose methotrexate or Actinomycin-D therapy should be selected as primary treatment in patients with non-metastatic or low-risk metastatic GTD. It is of importance to note that in cases of patients with a disease resistant to single agent chemotherapy, complete remission can regularly be achieved by using a combined chemotherapy. Necessary to emphasize that combined chemotherapy must be selected for primary treatment of patients with high risk GTD.
|Translated title of the contribution||Gestational trophoblastic neoplasia in Hungary|
|Number of pages||11|
|Journal||Magyar Noorvosok Lapja|
|Publication status||Published - Dec 1 2006|
ASJC Scopus subject areas
- Reproductive Medicine
- Obstetrics and Gynaecology