The role of adjuvant surgery in the management of gestational trophoblastic neoplasia.
OBJECTIVE
To evaluate the role of different surgical procedures combined with chemotherapy in the management of gestational trophoblastic neoplasia (GTN).


METHODS
A retrospective descriptive analysis of data was done using charts of diagnosed cases of GTN from 1996 to 2006. The patients were classified according to FIGO staging and WHO prognostic scoring. Surgical procedures were evaluated as to indications, hospital stay, remission rate and number of chemotherapy cycles needed to achieve remission.


RESULTS
One hundred thirty-four patients underwent at least 1 major surgery in the form of hysterectomy, with uterine perforation and profuse vaginal bleeding as an indication for surgery. Common indications for adjuvant surgery are completed family size and resistance to chemotherapy. Two patients had excision of liver metastases, and 3 patients had lung resection.


CONCLUSIONS
With the increasing use of early surgical intervention combined with chemotherapy, we feel that we are maximizing the benefit that can be derived by our patients from our treatment protocol. We are decreasing the number of chemotherapeutic cycles needed to attain remission and in effect decreasing the exposure of the patients to toxicity from the chemotherapy.
Cagayan
Ma Stephanie Fay S
MS
Department of Pharmacology and Toxicology and Section of Trophoblastic Diseases, College of Medicine, University of the Philippines-Philippine General Hospital, Manila, Philippines. faye_cagayan@hotmail.com
Magallanes
Maria Suyen
MS
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult
D000970:Antineoplastic Agents