[The role of hysterectomy in the therapy of gestational trophoblastic tumor].
OBJECTIVE
To evaluate the role of hysterectomy for patients with gestational trophoblastic tumor.


METHODS
A total of 68 cases of gestational trophoblastic neoplasia treated by hysterectomy from 1985-1997 at PUMC hospital was retrospectively analyzed. Thirty-eight cases were diagnosed as choriocarcinoma and 30 as invasive mole.


RESULTS
Twenty-three elder patients who didn't desire to preserve fertility were selected for hysterectomy after short courses of chemotherapy. Twenty-two of them had complete remission (95.6%). The average total course of chemotherapy was 4.2. Of twenty-seven chemo-refractory cases who were suspected of an isolated lesion in the uterus, delayed hysterectomy as an adjunct to chemotherapy was performed. Twenty of them achieved complete remission (74.1%), with an average 9.4 courses of chemotherapy. Emergency hysterectomy was indicated in 18 patients with uterine perforation or life-threatening hemorrhage. Seventeen of the emergent cases had complete remission (94.4%), who had received an average 7.6 courses of chemotherapy.


CONCLUSIONS
Although the development of effective chemotherapy has resulted in improved survival of patients with gestational trophoblastic tumor, hysterectomy remains an important adjunct treatment in a selected subset of patients. Modified radical hysterectomy is recommended for the indicated patients.
Xiang
Y
Y
Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730.
Yang
X
X
Du
J
J
D005260:Female; D006801:Humans; D007044:Hysterectomy; D011247:Pregnancy; D014328:Trophoblastic Neoplasms / Q000188:drug therapy / Q000601:surgery*; D014594:Uterine Neoplasms / Q000188:drug therapy / Q000601:surgery*