SavedAdd your journal

Journals / Türk Jinekoloji ve Obstetrik Derneği Dergisi / 2012 / Cilt: 9 - Sayı: 2

The role of hysterectomy ın the treatment of gestatıonal trophoblastıc neoplazıas: a sıngle center experıence of 17 years

Gestasyonel trofoblastik neoplazilerin tedavisinde histerektominin rolü: tek merkezin 17 yıllık deneyimi

Muzaffer SANCI
Aşkın DOĞAN
Volkan EMİRDAR
İbrahim Ege ERTAŞ
Yusuf YILDIRIM
Ahmet GÜLER
Pages
110–115
Publication Date
2022-11-05
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Overall 16/17 (94%) patients performed hysterectomy for GTN obtained complete remission.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: To identify indications for hysterectomy in patients with gestational trophoblastic neoplazia (GTN) and to evaluate outcomes of hysterectomy in those patients.
📊
Key Findings & Data:Design: Between December 1994 and December 2011, patients operated with the diagnosis of GTN were evaluated retrospectively.
💡
Conclusion & Impact:Overall 16/17 (94%) patients performed hysterectomy for GTN obtained complete remission.
🔬Design:Research Article
📍Scope:2011 Verileri
⚙️Variables:Domain Parameters

Abstract

Objective: To identify indications for hysterectomy in patients with gestational trophoblastic neoplazia (GTN) and to evaluate outcomes of hysterectomy in those patients. Design: Between December 1994 and December 2011, patients operated with the diagnosis of GTN were evaluated retrospectively. Setting: Department of Gynecologic Oncology, Aegean Obstetrics and Gynecology Education and Research Hospital, Izmir. Patients and Intervention: 17 patients with GTN undergoing total abdominal hysterectomy. Main Outcome Measures: Age at surgery, chemotherapy regimens prior to surgery, tumor stage, pre-treatment risk scores, hysterectomy indications, postoperative treatments, recurrence rates and prognosis were evaluated. Descriptive analyses were used to present findings. Results: Of the total 267 patents followed-up for gestational trophoblastic disease (GTD), 29 (10.8%) needed chemotherapy and 17 (6.3%) underwent hysterectomy. Mean age during surgery was 45.1 ± 5.4 [range: 32-58]. Sixteen (94.1%) of 17 patients received single agent or multi-agent chemotherapy prior to hysterectomy. Resistance to chemotherapy n = 8, (47%); life-threatening bleeding n = 5, (29.5%) and advanced age n = 4, (23.5%) were the hysterectomy indications. There were no mortality and major operative morbidity. Postoperatively, six (35.2%) patients were treated with 3 cures etoposide, methotrexate, actinomycin D, cyclophosphamide and vincristine (EMA-CO) regimen and one (5.8%) were treated with 2 cures methotrexate. Mean follow-up duration after hysterectomy was 91.8 ± 37.5 months [range: 6-204 months]. Overall 16/17 (94%) patients performed hysterectomy for GTN obtained complete remission. One patient with choriocarcinoma having resistance to chemotherapy prior to surgery relapsed and died of disease. Choriocarcinoma 8 (%47) was the most frequent pathology followed by invasive mole 5 (%29.5)and placental site trophoblastic tumor 4 (%23.5).Conclusion: Hysterectomy is a safe, useful and effective treatment method especially in patients having resistantdisease to conventional GTD treatment and in selected cases with GTN.

Özet

Amaç: Histerektomi yapılan gestasyonel trofoblastik neoplazi (GTN) tanılı vakaların endikasyonlarını belirlemekve sonuçlarını değerlendirmektir.Planlama: Aralık 1994 ve Aralık 2011 tarihleri arasında, gestasyonel trofoblastik GTN tanısı alarak ameliyat kararıverilen hastalar retrospektif olarak değerlendirildi.Ortam: Ege Doğumevi ve Kadın Hastalıları Eğitim-Arafltırma Hastanesi, Jinekolojik Onkoloji Kliniği, İzmir. Hastalar ve giriflim: Total abdominal histerektomi yapılan 17 GTN'li hasta.Değerlendirme parametreleri: Histerektomi yaflı, cerrahi öncesi aldıkları kemoterapiler, tümör evresi, tedavi öncesirisk skoru, histerektomi endikasyonları, postoperatif tedavileri, rekürrens oranları ve prognozları değerlendirildi.Bulgularımız tanımlayıcı analizler ile sunuldu.Sonuç: Toplam 267 gestasyonel trofoblastik hastalık (GTH) tanısıyla takip edilen hastanın, 29'una (%10.8) kemoterapi gerekti ve 17'sine (%6.3) histerektomi uygulandı. Cerrahi sırasında yafl ortalaması 45.1 ± 5.4 ve aralığı [32-58] idi.16 (%94.1) hasta histerektomi öncesi tek veya multi ajan kemoterapi aldı. Kemoterapiye rezistans n = 8, (%47);yaflamı tehdit eden vaginal kanama n = 5, (%29.5) ve ileri yafl n = 4, (%23.5) operasyon endikasyonları idi. Hiçbirhastada intra ve postoperatif mortalite ve majör morbidite gerçekleflmedi. Postoperatif, 6 (35.2%) hastaya 3 küretoposid, methotreksat, aktinomisin D, siklofosfami ve vinkristin (EMA-CO) ve 1 (%5.8) hastada 2 kür metotreksatile tedavi edildi. Operasyon sonrası ortalama takip süresi 91.8 ± 37.5 [6-204] ay olarak tespit edildi. GTN tanısıylahisterektomi yapılan 17 hastanın 16'sında (%94) tam remisyon sağlandı. Cerrahi öncesi kemoterapi rezistansı nedeniylehisterektomi yapılan koryokarsinom tanılı 1 hasta nükse sekonder hayatını kaybetdi. Koriokarsinom 8 (%47) en sıkpatolojik tanıydı ve takip eden sırayla diğerleri invaziv mol 5 (%29.5) ve plasental site trofoblastik tümör 4 (%23.5)idi.

🔖

Cite This Article

SANCI, M., DOĞAN, A., EMİRDAR, V., ERTAŞ, İ. E., YILDIRIM, Y., GÜLER, A. (2022). The role of hysterectomy ın the treatment of gestatıonal trophoblastıc neoplazıas: a sıngle center experıence of 17 years. Türk Jinekoloji ve Obstetrik Derneği Dergisi, Cilt: 9 - Sayı: 2, 110–115. https://ajindex.com/articles/631567

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (16)

  1. Altieri A, Franceschi S, Ferlay J, Smith J, La Vecchia C. Epidemiology and aetiology of gestational trophoblastic diseases. Lancet Oncol. 2003
  2. 4(11): 670- 8. Ozalp SS, Yalcin OT, Tanir HM: Hydatidiform mole in Turkey from 1932 to 2000. Int J Gynecol Obstet. 2001
  3. 73(3): 257- 8. Kohorn EI. The new FIGO 2000 staging and risk factor scoring system for gestational trophoblastic disease: Description and critical assessment. Int J Gynecol Cancer 2001
  4. 11(1): 73- 7. Uyar I, Gulhan I, Hasegeli S, Hanhan M, Ozeren M. [Hydatidiform mole and false low level of hCG]. Turkiye Klinikleri J Gynecol Obst. 2011
  5. 21(1): 47- 9. Soper JT, Mutch DG, Schink JC
  6. American College of Obstetricians and Gynecologists. Diagnosis and treatment of gestational trophoblastic disease: ACOG Practice Bulletin No. 53. Gynecol Oncol. 2004
  7. 93(3): 575- 85. Review. Özalp SS. Follow up in gestational trophoblastic disease. Turkiye Klinikleri J Gynecol Obst. 2004
  8. 14(3): 182- 6. Ghaemmaghami F, Ashrafgangooei T, Gillani MM, Mosavi A, Behtash N. Major surgeries performed for gestational trophoblastic neoplasms in a teaching hospital in Tehran, Iran. J Gynecol Oncol. 2011
  9. 22(2): 97- 102. Hammond CB, Weed JC Jr, Currie JL. The role of operation in the current therapy of gestational trophoblastic disease. Am J Obstet Gynecol. 1980
  10. 136(7): 844- 58. Pisal N, North C, Tidy J, Hancock B. Role of hysterectomy in management of gestational trophoblastic disease. Gynecol Oncol. 2002
  11. 87(2): 190- 2. Doumplis D, Al-Khatib K, Sieunarine K, Lindsay I, Seckl M, Bridges J, et al. A review of the management by hysterectomy of 25 cases of gestational trophoblastic tumours from March 1993 to January 2006. BJOG. 2007
  12. 114(9): 1168-7 1. Lurain JR, Singh DK, Schink JC. Role of surgery in the management of high-risk gestational trophoblastic neoplasia. J Reprod Med. 2006
  13. 51(10): 773- 6. Alazzam M, Hancock BW, Tidy J. Role of hysterectomy in managing persistent gestational trophoblastic disease. J Reprod Med. 2008
  14. 53(7): 519- 24. Clark RM, Nevadunsky NS, Ghosh S, Goldstein DP, Berkowitz RS. The evolving role of hysterectomy in gestational trophoblastic neoplasia at the New England Trophoblastic Disease Center. J Reprod Med. 2010
  15. 55(5-6): 194- 8. Suzuka K, Matsui H, Iitsuka Y, Yamazawa K, Seki K, Sekiya S. Adjuvant hysterectomyin low-risk gestational trophoblastic disease. Obstet Gynecol. 2001
  16. 97(3): 431- 4. Köflüfl A, Köflüfl M, Çapar M. Management of gestational trophoblastic neoplasms in our clinic. Turkiye Klinikler