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[Management of gestational trophoblastic disease].

Abstract
Gestational trophoblastic diseases comprise of hydatiform mole, invasive mole, choriocarcinoma and placental site trophoblastic tumor. Most of those pathologies are chemosensitive and have excellent prognosis, allowing preserving women's fertility because of the low relapse rate during further pregnancies. Physiopathological mechanisms and risk factors are now better understood. Hydatiform moles have to be treated by suction rather than curettage. Placental site trophoblastic tumors are particular chemoresistant pathologies, not secreting hCG which needs specific management. Trophoblastic tumors can be divided into two groups: a low risk group treated by monotherapy, most often by Methotrexate or actinomycine D, with survey about 100% and a high risk group treated by polychemotherapy (Etoposide, Methotrexate, actinomycine D, cyclophosphamide, Vincristine with survey of 86%. Chemorefractarory patients keep deep prognosis with 5 years survival rate of 43%, which allow development of new therapy in this indication. Measurement of hCG remains today central for supervision. A specialised management by an experimented team is essential to give patients better chance of recovery.
AuthorsS Noal, F Joly, E Leblanc
JournalGynecologie, obstetrique & fertilite (Gynecol Obstet Fertil) Vol. 38 Issue 3 Pg. 193-8 (Mar 2010) ISSN: 1769-6682 [Electronic] France
Vernacular TitlePrise en charge d'une tumeur trophoblastique gestationnelle.
PMID20189434 (Publication Type: English Abstract, Journal Article, Review)
CopyrightCopyright 2010 Elsevier Masson SAS. All rights reserved.
Chemical References
  • Antineoplastic Agents
  • Chorionic Gonadotropin
Topics
  • Adult
  • Antineoplastic Agents (therapeutic use)
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Choriocarcinoma (diagnosis, epidemiology, therapy)
  • Chorionic Gonadotropin (blood)
  • Drug Resistance, Neoplasm
  • Female
  • Gestational Trophoblastic Disease (diagnosis, epidemiology, therapy)
  • Humans
  • Hydatidiform Mole (diagnosis, epidemiology, therapy)
  • Pregnancy
  • Prognosis
  • Risk Factors
  • Suction
  • Trophoblastic Tumor, Placental Site (diagnosis, epidemiology, therapy)
  • Uterine Neoplasms (diagnosis, epidemiology, therapy)

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