Management and prognosis of patients with liver metastases from gestational trophoblastic neoplasia: a retrospective cohort study

• Published in: Cancer management and research Vol. 10; pp. 557 - 563
• Main Authors: Zong, Liju, Yang, Junjun, Wang, Xiaoyu, Kong, Yujia, Ren, Tong, Zhao, Jun, Feng, Fengzhi, Wan, Xirun, Xiang, Yang
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2018; Taylor & Francis Ltd; Dove Medical Press
• Subjects: Cancer; Cancer metastasis; Cancer treatment; Care and treatment; Chemotherapy; choriocarcinoma; Cohort analysis; Disease; Family medical history; Gynecology; Health aspects; Hospitals; Liver; Medical imaging; Medical prognosis; Medical records; Metastasis; multidrug chemotherapy failure; NMR; Nuclear magnetic resonance; Obstetrics; Original Research; Patients; Pregnancy; Prognosis; risk factor; Tomography; Trophoblastic tumors; Ultrasonic imaging; Vincristine; China; Beijing China; hepatic metastasis; multidrug chemotherapy; FIGO score; multidrug chemotherapy failure
• ISSN: 1179-1322; 1179-1322
• DOI: 10.2147/CMAR.S160606

The aims of this study were to analyze the clinical features, identify prognostic factors, and evaluate the survival outcomes of gestational trophoblastic neoplasia (GTN) patients with liver metastases. Forty patients with liver metastases arising from GTNs, who were treated at the Peking Union Medical College Hospital (Beijing, People's Republic of China) between January 1999 and December 2015, were recruited from the institutional database, and their medical records were reviewed. Univariate and multivariate analyses were performed to identify independent risk factors for survival. Twenty-seven patients (67.5%) achieved complete remission after multidrug chemotherapy treatment. The remaining 13 patients (32.5%) had disease progression. Eighteen patients (45.0%) died during treatment or follow-up. A history of failed multidrug chemotherapy was an independent risk factor for survival (OR: 5.57, 95% CI: 1.42-21.86, =0.014). Moreover, patients with an International Federation of Gynecology and Obstetrics (FIGO) score of >16 had a significantly poorer survival than those with a score of ≤16 ( <0.001). GTN with liver metastasis is a very rare disease with a relatively poor prognosis. Patients with a history of failed multidrug chemotherapy and a FIGO score of >16 have poorer survival outcomes. Multidrug chemotherapy is the key to the management of GTN patients with liver metastases.