[Management and risk factors of recurrent gestational trophoblastic tumor].
OBJECTIVE
To analyze the management, prognosis and prognostic risk factors of recurrent gestational trophoblastic tumor (GTT).


METHODS
One thousand one hundred and thirty GTT patients, aged 29 +/- 6, were hospitalized and treated and 901 of them got complete remission (CR). Among these CR patients, 31 suffered relapsed. The clinical data of these 31 cases were analyzed retrospectively.


RESULTS
Thirty-one patients suffered 15.3 months (6-72 months) after the cessation of treatment with an overall recurrence rate of 3.4% (31/901). Four of the 31 patients suffered relapse repeatedly (totally seven times), resulting in an overall re-recurrence rate of 22.6% (7/31). Twenty-five of the 31 patients were re-hospitalized and received treatment. Eighteen of them got complete remission (CR), 3 got partial remission (PR), and 4 died of progress of the disease (PD). The major adverse prognostic risk factors included: clinical stage (P < 0.05), an interval of more than 12 months from the antecedent pregnancy to chemotherapy (OR = 3.170, P < 0.05), declination of beta-hCG level back to normal titer after more than seven courses of chemotherapy (OR = 4.775, P < 0.05), and less than two courses of consolidation chemotherapy (OR = 0.441, P < 0.05).


CONCLUSIONS
More attention should be given to those GTT patients with adverse prognostic risk factors. Multi-drug and multiple route chemotherapy and/or combined surgical intervention can be used to improve the cure rate and lower the re-recurrence rate of the GTT recurrent patients.
Yang
Juan-jun
JJ
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Xiang
Yang
Y
Wan
Xi-run
XR
Shi
Jun-rong
JR
Wei
Shuang-mei
SM
Yang
Xiu-yu
XY
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D011247:Pregnancy; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors