title: [Analysis of the treatment and prognosis for gestational trophoblastic neoplasia patients with urinary system and adrenal glands metastasis].
abstract: OBJECTIVE
  To analyze the treatment and prognosis of patients with gestational trophoblastic neoplasia with urinary system and adrenal glands metastasis.
  
  
  METHODS
  The treatment and prognoses of 32 patients with gestational trophoblastic neoplasia with urinary system and adrenal glands metastasis from Dec. 1990 to Dec. 2010 at Peking Union Medical College Hospital, Chinese Academy of Medical Sciences were respectively reviewed.
  
  
  RESULTS
  Treatment methods: all 32 patients received 9 courses(in average) of a multi- drug chemotherapy in our hospital (range 1-24 coures). Among them, 3 patients with bladder metastasis received intravesical chemotherapy of fluorouracil. 9 patients received surgical treatments in other hospital and 15 patients received surgical treatments while undergoing chemotherapy in our hospital. Treatment results: after the treatments, of the 32 patients, 21 (66%) patients achieved complete remission, 3(9%) exhibited partial remission and 8 (25%) progressed. Seven patients with renal metastasis achieved complete remission. Two patients with adrenal glands metastasis achieved complete remission. Nine patients with urinary bladder metastasis achieved complete remission. Seven patients with ureters metastasis achieved complete remission. Two (10% ) of 21 patients with complete remission relapsed.
  
  
  CONCLUSIONS
  Multidrug and multiroute chemotherapy is the main strategy for patients with gestational trophoblastic neoplasia with urinary system and adrenal glands metastasis. The prognoses of patients with renal or adrenal glands metastasis are much worse than those in patients with bladder and ureters metastasis because of concomitant multiogran metastasis. Adequate attention should be given to patients with renal or adrenal glands metastasis. Individual treatment, assisted by surgery when necessary, may be carried out for these patients to achieve a better outcome.
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Junjun
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China. Email: rentong89@163.com.
authors.forename: Tong
authors.initials: T
authors.lastname: Ren
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Fengzhi
authors.initials: F
authors.lastname: Feng
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Xirun
authors.initials: X
authors.lastname: Wan
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Xiang
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000556:secondary*; D000311:Adrenal Glands / Q000473:pathology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002681:China / Q000453:epidemiology; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D031901:Gestational Trophoblastic Disease / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014571:Urologic Neoplasms / Q000556:secondary*
chemical_list: D005472:Fluorouracil