High-risk metastatic gestational trophoblastic disease: further stratification into two clinical entities.
Forty-two of sixty-seven patients (62.7%) treated for high-risk metastatic trophoblastic disease achieved and maintained complete remissions. The survival rate was significantly improved in those patients with scores lower than 8 according to a modification of the World Health Organization (WHO) prognostic scoring system. A low score was associated with a higher probability of response to single-agent therapy, although the difference was not statistically significant. The score, however, was significantly associated with response to multiagent chemotherapy with methotrexate, actinomycin D, and cyclophosphamide (P = 0.0004). Therefore, future trials of new combinations of chemotherapy in high-risk patients should be stratified according to the patients' prognostic scores.
Gordon
A N
AN
Department of Gynecology, University of Texas M.D. Anderson Hospital and Tumor Institute, Houston 77030.
Gershenson
D M
DM
Copeland
L J
LJ
Stringer
C A
CA
Morris
M
M
Wharton
J T
JT
D005260:Female; D006801:Humans; D011247:Pregnancy; D011379:Prognosis; D012307:Risk Factors; D014328:Trophoblastic Neoplasms / Q000188:drug therapy* / Q000401:mortality; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000401:mortality