Cancer Management and Research (Mar 2018)
Management and prognosis of patients with liver metastases from gestational trophoblastic neoplasia: a retrospective cohort study
Abstract
Liju Zong, Junjun Yang, Xiaoyu Wang, Yujia Kong, Tong Ren, Jun Zhao, Fengzhi Feng, Xirun Wan, Yang Xiang Departments of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China Purpose: 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. Patients and methods: 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. Results: 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, P=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 (P<0.001). Conclusion: 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. Keywords: multidrug chemotherapy failure, FIGO score, multidrug chemotherapy, hepatic metastasis
