Chinese medical sciences journal = Chung-kuo i hsueh k'o hsueh tsa chih · 2000
The role of hysterectomy in the therapy of gestational trophoblastic tumor.
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Xiang Y, Yang X, Du J, Song H
Аннотация
OBJECTIVE: To evaluate the role of hysterectomy for patients with gestational trophoblastic tumor.
METHODS: We retrospectively analyzed 68 cases of gestational trophoblastic neoplasia treated by hysterectomy from 1985 to approximately 1997 at PUMC hospital. Thirty-eight cases were diagnosed of choriocarcinoma and 30 were invasive mole.
RESULTS: Twenty-three elder patients who didn't desire to preserve fertility were selected for hysterectomy after shorter courses of chemotherapy, 22 of them had a complete remission (95.6%), the total average courses of chemotherapy was 4.2. Of twenty-seven chemorefractory cases who were suspected of a refractory isolated lesion in the uterus, delayed hysterectomy as an adjunct to chemotherapy was performed, 20 of them got a complete remission (71.1%), the total average courses of chemotherapy were 9.4. Emergency hysterectomy is indicated in 18 patients with uterine perforation or life-threatening hemorrhage, 17 cases had a complete remission (94.4%), the total average courses of chemotherapy were 7.6.
CONCLUSION: Although the development of effective chemotherapy has resulted in improved survival of patients with gestational trophoblastic tumor, hysterectomy remains an important adjuncts in the treatment of a selected subset of patients; in order to operate more completely and prevent recurrence, it's better to perform extended hysterectomy for the indicated patients.
METHODS: We retrospectively analyzed 68 cases of gestational trophoblastic neoplasia treated by hysterectomy from 1985 to approximately 1997 at PUMC hospital. Thirty-eight cases were diagnosed of choriocarcinoma and 30 were invasive mole.
RESULTS: Twenty-three elder patients who didn't desire to preserve fertility were selected for hysterectomy after shorter courses of chemotherapy, 22 of them had a complete remission (95.6%), the total average courses of chemotherapy was 4.2. Of twenty-seven chemorefractory cases who were suspected of a refractory isolated lesion in the uterus, delayed hysterectomy as an adjunct to chemotherapy was performed, 20 of them got a complete remission (71.1%), the total average courses of chemotherapy were 9.4. Emergency hysterectomy is indicated in 18 patients with uterine perforation or life-threatening hemorrhage, 17 cases had a complete remission (94.4%), the total average courses of chemotherapy were 7.6.
CONCLUSION: Although the development of effective chemotherapy has resulted in improved survival of patients with gestational trophoblastic tumor, hysterectomy remains an important adjuncts in the treatment of a selected subset of patients; in order to operate more completely and prevent recurrence, it's better to perform extended hysterectomy for the indicated patients.