The Journal of reproductive medicine · 2014
The encouraging prognosis of nongestational ovarian choriocarcinoma with lung metastases.
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Liu Ying, Yang Junjun, Ren Tong, Zhao Jun, Feng Fengzhi, Wan Xirun, Xiang Yang
Аннотация
OBJECTIVE: To study nongestational ovarian choriocarcinoma (NGOC) with lung metastases: its early diagnosis, optimal therapeutic method, and prognosis.
STUDY DESIGN: Twelve cases of NGOC with lung metastases treated in Peking Union Medical College Hospital from 1982-2011 were analyzed retrospectively. The 12 cases included 9 pure NGOCs and 3 mixed with other germ cell tumors (mature teratoma, endodermal sinus tumor and embryonal carcinoma components, and dysgerminoma, respectively). Chemotherapy was given in all 12 cases, mainly including EMA/CO, BEP, and
RESULTS: The median age for the cases was 23.9 years. Abdominal pain was the most common symptom (7/12). Follow-up was available for 11 cases, ranging from 17-174 months (median, 86.6 months). Of those, only 1 patient died of the disease, at 42 months from the disease onset. The other patient for whom follow-up was not available gave up treatment due to chemoresistance and disease progression. An overall sustained remission had been achieved in 10 cases (83.3%).
CONCLUSION: Surgery combined with the appropriate chemotherapy regimen can improve therapeutic efficacy and survival in the treatment of NGOC with lung metastasis, even in recurrent or chemorefractory cases. Commencement of EMA/CO chemotherapy, which seems to be associated with better prognosis, should be considered as a good choice of treatment. Conservative surgery is acceptable for young patients desiring to preserve fertility.
STUDY DESIGN: Twelve cases of NGOC with lung metastases treated in Peking Union Medical College Hospital from 1982-2011 were analyzed retrospectively. The 12 cases included 9 pure NGOCs and 3 mixed with other germ cell tumors (mature teratoma, endodermal sinus tumor and embryonal carcinoma components, and dysgerminoma, respectively). Chemotherapy was given in all 12 cases, mainly including EMA/CO, BEP, and
RESULTS: The median age for the cases was 23.9 years. Abdominal pain was the most common symptom (7/12). Follow-up was available for 11 cases, ranging from 17-174 months (median, 86.6 months). Of those, only 1 patient died of the disease, at 42 months from the disease onset. The other patient for whom follow-up was not available gave up treatment due to chemoresistance and disease progression. An overall sustained remission had been achieved in 10 cases (83.3%).
CONCLUSION: Surgery combined with the appropriate chemotherapy regimen can improve therapeutic efficacy and survival in the treatment of NGOC with lung metastasis, even in recurrent or chemorefractory cases. Commencement of EMA/CO chemotherapy, which seems to be associated with better prognosis, should be considered as a good choice of treatment. Conservative surgery is acceptable for young patients desiring to preserve fertility.
Предметные рубрики MeSH
Abdominal PainAdolescentAdultAntineoplastic Combined Chemotherapy ProtocolsChemotherapy, AdjuvantChildChinaChoriocarcinoma, Non-gestationalCyclophosphamideDactinomycinEtoposideFemaleHumansLung NeoplasmsMethotrexateMiddle AgedNeoplasm StagingOvarian NeoplasmsPrognosisRemission InductionRetrospective StudiesTreatment OutcomeVincristineYoung Adult