title: High-risk metastatic gestational trophoblastic disease: further stratification into two clinical entities.
abstract: 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.
authors.affiliation: Department of Gynecology, University of Texas M.D. Anderson Hospital and Tumor Institute, Houston 77030.
authors.forename: A N
authors.initials: AN
authors.lastname: Gordon
authors.forename: D M
authors.initials: DM
authors.lastname: Gershenson
authors.forename: L J
authors.initials: LJ
authors.lastname: Copeland
authors.forename: C A
authors.initials: CA
authors.lastname: Stringer
authors.forename: M
authors.initials: M
authors.lastname: Morris
authors.forename: J T
authors.initials: JT
authors.lastname: Wharton
mesh_terms: 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