Does gestational trophoblastic disease require chemotherapy?

Background. Gestational trophoblastic neoplasia (GTN) is a highly curable group of pregnancy‐related tumours; however, approximately 25% of GTN tumours will be resistant to, or will relapse after, initial chemotherapy. These resistant and relapsed lesions will require salvage chemotherapy with or without surgery.

What chemotherapy is used for choriocarcinoma?

If you have high risk PTD or choriocarcinoma, you might have the drug methotrexate by drip into a vein (intravenous infusion). This is followed a week later by the drugs actinomycin and etoposide. Or you may have a combination of chemotherapy drugs called EMA-CO.

What is the treatment for GTD?

GTD is typically curable, especially when found early. The main treatments for GTD are surgery and/or chemotherapy. Descriptions of the common types of treatments used for GTD are listed below. Your care plan may include treatment for symptoms and side effects, an important part of medical care.

Is chemotherapy always necessary for patients with nonmetastatic gestational trophoblastic neoplasia with histopathological diagnosis of choriocarcinoma?

Conclusion: In order to avoid exposing patients unnecessarily to chemotherapy, close surveillance of women with pathological diagnosis of nonmetastatic GCC seems to be a safe practice, particularly for those who have a normal hCG at the time of diagnosis.

What side effects does chemotherapy have?

Here’s a list of many of the common side effects, but it’s unlikely you’ll have all of these.

  • Tiredness. Tiredness (fatigue) is one of the most common side effects of chemotherapy.
  • Feeling and being sick.
  • Hair loss.
  • Infections.
  • Anaemia.
  • Bruising and bleeding.
  • Sore mouth.
  • Loss of appetite.

How long is chemo for molar pregnancy?

Doctors administer chemotherapy in cycles of treatment and recovery. These cycles are generally 2–3 weeks long and may repeat for 3–6 months.

What is gestational trophoblastic neoplasia?

Recurrent gestational trophoblastic neoplasia (GTN) is cancer that has recurred (come back) after it has been treated. The cancer may come back in the uterus or in other parts of the body. Gestational trophoblastic neoplasia that does not respond to treatment is called resistant GTN.

Can GTD come back?

The risk of GTD coming back is highest in the first few months. You will need to wait a year after finishing your treatment before you try and get pregnant again, if you have chemotherapy . It’s important to know that having a GTD does not increase your risk of having a baby with abnormalities.

Is gestational trophoblastic disease fatal?

In total, 1044 patients were admitted during the study period, 164 cases (15.7%) of gestational trophoblastic neoplasia (GTN) were diagnosed and 21 deaths occurred leading to a specific lethality of 12.8% (21/164).

What are the symptoms of gestational trophoblastic disease?

Abnormal vaginal bleeding during or after pregnancy. A uterus that is larger than expected at a given point in the pregnancy. Severe nausea or vomiting during pregnancy. High blood pressure at an early point in the pregnancy, which may include headaches and/or swelling of the feet and hands.

What is metastatic gestational trophoblastic neoplasia?

Gestational Trophoblastic Neoplasia (GTN) refers to a pathologic condition that is characterized by aggressive invasion of the endometrium and myometrium by trophoblastic cells and is divided to four different pathologic entities: invasive mole, gestational choriocarcinoma, placental site trophoblastic tumour and …

What are the worst side effects of chemotherapy?

  • Infection and a weakened immune system. Cancer and the treatment of it can weaken the immune system.
  • Bruising and bleeding more easily. Chemotherapy can cause a person to bruise or bleed more easily.
  • Hair loss.
  • Nausea and vomiting.
  • Neuropathy.
  • Constipation and diarrhea.
  • Rash.
  • Mouth sores.

What are the treatment options for gestational trophoblastic neoplasia?

Treatment of low-risk gestational trophoblastic neoplasia (GTN) (invasive mole or choriocarcinoma) may include the following: Chemotherapy with one or more anticancer drugs. Treatment is given until the beta human chorionic gonadotropin (β-hCG) level is normal for at least 3 weeks after treatment ends.

Can a gestational trophoblastic tumor spread to the lungs?

An epithelioid trophoblastic tumor (ETT) is a very rare type of gestational trophoblastic neoplasia that may be benign or malignant. When the tumor is malignant, it may spread to the lungs. Age and a previous molar pregnancy affect the risk of GTD. Anything that increases your risk of getting a disease is called a risk factor.

Where does a placental-site trophoblastic tumor ( pstt ) form?

Placental-site trophoblastic tumors. A placental-site trophoblastic tumor (PSTT) is a rare type of gestational trophoblastic neoplasia that forms where the placenta attaches to the uterus. The tumor forms from trophoblast cells and spreads into the muscle of the uterus and into blood vessels.

What kind of chemotherapy is used for GTN?

Treatment of high –risk GTN should be initiated as soon as possible, within 24-48 hrs of diagnosis whenever possible. Patients with high-risk GTN are generally treated with combination chemotherapy. The most commonly used regimen is EMA-CO (etoposide, methotrexate/folinic acid, actinomycin-D / vincristine, cyclophosphamide) (GOTDEMACO protocol).