GESTATIONAL TROPHOBLASTIC DISEASE - TREATMENT RESULTS AT THE BREWER TROPHOBLASTIC DISEASE CENTER

  • 1 January 1982
    • journal article
    • research article
    • Vol. 60  (3) , 354-360
Abstract
A total of 359 patients with gestational trophoblastic disease (choriocarcinoma and invasive mole) received complete treatment at the Brewer Trophoblastic Disease Center of Northwestern University Medical School from 1962-1978. Data were gathered as of Dec. 31, 1978, to permit a minimum follow-up of 2 yr. An overall remission rate of 92% was achieved as follows: 100% (185/185) for nonmetastatic disease and 83% (144/174) for metastatic disease. All 200 patients with invasive mole and 129 of 159 patients (81%) with choriocarcinoma were cured. Chemotherapy was the main form of treatment, with adjuvant surgery and radiation therapy being used in selected patients. The following 5 factors were determined to significantly influence response to treatment in patients with metastatic disease: clinicopathologic diagnosis of choriocarcinoma vs. invasive mole (71 vs. 100%, P .mchlt. 0.0005); pretreatment human chorionic gonadotropin titer > 100,000 IU/l and time > 4 mo. from pregnancy event to treatment (62 vs. 93%, P .mchlt. 0.0005); metastases to sites other than lung and/or vagina (37 vs. 92%, P .mchlt. 0.0005); antecedent term gestation compared with hydatidiform mole, abortion and ectopic pregnancy (56 vs. 79%, P < 0.02); prior unsuccessful chemotherapy compared with no previous treatment (48 vs. 83%, P .mchlt. 0.0005). The value of secondary chemotherapy and adjuvant irradiation was evaluated. Relapse from remission was also studied.