المؤلفون: Robert E. Coleman, Barry W. Hancock, Paul Silcocks, R. Nakielny, James Nevin, Paul Lorigan

المصدر: Gynecologic Oncology. 78:92-96

مصطلحات موضوعية: Adult, medicine.medical_specialty, Lung Neoplasms, Time Factors, Adolescent, medicine.medical_treatment, Salvage treatment, Leucovorin, Salvage therapy, Trophoblastic Neoplasms, Abortion, Severity of Illness Index, World health, Gestational trophoblastic tumor, Folinic acid, Predictive Value of Tests, Pregnancy, Risk Factors, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, Humans, Medicine, Chorionic Gonadotropin, beta Subunit, Human, Salvage Therapy, Clinical Trials as Topic, Chemotherapy, business.industry, Age Factors, Obstetrics and Gynecology, Middle Aged, Prognosis, Surgery, Logistic Models, Methotrexate, ROC Curve, Oncology, Practice Guidelines as Topic, Female, Tomography, X-Ray Computed, business, medicine.drug

الوصف: Objective. The aim of the study was to initiate a search for factors which might independently predict the need for salvage therapy in patients with low-risk gestational trophoblastic tumor. Methods. The independent effect of six factors on the need for salvage chemotherapy was assessed in patients with low-risk gestational trophoblastic tumor who were treated with low-dose methotrexate and folinic acid. The accuracies of World Health Organization and Charing Cross Hospital scores were also compared. Results. Age, pretreatment βhCG, antecedent pregnancy–treatment interval, and the presence of chest metastases detected on chest X ray were not significantly predictive. The size of tumor ( P = 0.001) and the presence of chest metastases on chest computerized tomography ( P = 0.00028) had independent, statistically significant predictive power, and a simple prognostic index was derived from these variables. The World Health Organization score was found to be significantly better than the Charing Cross Hospital score. The accuracy of the simple prognostic index was slightly greater than that of the World Health Organization score, although this was not statistically significant. Conclusions. These results confirm that patients entered into studies of different therapies for low-risk gestational trophoblastic tumor should be stratified and that a simple score, derived from the results of tumor size and chest computerized tomography, is potentially as good as the World Health Organization score for predicting the need for salvage therapy.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ab4d9555fbef21e763204888d7c466a0Test
https://doi.org/10.1006/gyno.2000.5835Test

المؤلفون: Robert E. Coleman, N. Bright, Barry W. Hancock, Paul Lorigan, Shailendra Sharma

المصدر: Gynecologic oncology. 78(3 Pt 1)

مصطلحات موضوعية: Molar, Adult, medicine.medical_specialty, Adolescent, ABO Blood-Group System, Mandibular second molar, Molar pregnancy, stomatognathic system, Pregnancy, medicine, Ethnicity, Humans, Registries, Risk factor, Child, Gynecology, business.industry, Gestational trophoblastic disease, Incidence (epidemiology), Incidence, Age Factors, Obstetrics and Gynecology, Hydatidiform Mole, medicine.disease, Oncology, England, Relative risk, Uterine Neoplasms, Female, Neoplasm Recurrence, Local, business

الوصف: The aim of this study was to examine the incidence and characteristics of women who develop a second molar pregnancy after a previous episode of gestational trophoblastic disease.A retrospective analysis was carried out on completed registration forms from referring hospitals in the North of England to the Sheffield Trophoblastic Screening Service over a 13-year period. All cases of second molar pregnancy were identified. Details of histology, blood group, ethnic origin, age, and subsequent pregnancies were examined.Between 1 January 1985 and 31 December 1997, 5030 patients were registered for follow-up and 275 (5.5%) required treatment for persistent disease. Thirty-five women had a subsequent molar pregnancy, a total of 0.70% of all registrations. There was no significant difference in age at first registration between those who were registered for one molar event and those who developed a subsequent molar pregnancy. The risk of a second molar event was highest in the second year after the initial diagnosis and reduced thereafter. There was a trend toward an increased risk of second molar pregnancy in Indian/Pakistani women when compared to Caucasian women (relative risk 2.4) but this was not significant at conventional levels. There was a significantly increased incidence of blood group B in patients that developed a molar pregnancy when compared to the normal population (P0.05), but there was no difference in distribution of blood group between those registered for their first molar event and those with two or more events. Patients who presented with a partial mole tended to have a partial mole as the second event but patients who presented with a complete mole were at risk of a subsequent complete mole, partial mole, or choriocarcinoma. Six percent of patients required chemotherapy for the second molar event, indicating no increase in aggressiveness in second moles. Two patients had three molar events.In the United Kingdom the risk of second molar pregnancy is less than 1%. There is an increased risk of molar pregnancy in women with blood group B and a trend toward an increased risk of second molar pregnancy in Indian/Pakistani women. Only 6% of patients required chemotherapy for the second mole; a second molar pregnancy is not an indication for chemotherapy.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5a3ac7a773a91434b2a47c07312172e6Test
https://pubmed.ncbi.nlm.nih.gov/10985882Test