title: Fertility-sparing uterine lesion resection for young women with gestational trophoblastic neoplasias: single institution experience.
abstract: OBJECTIVE
  To evaluate the oncological safety and pregnant outcomes of fertility-sparing uterine lesion resection in treating gestational trophoblastic neoplasias.
  
  
  RESULTS
  After the treatment of surgery and chemotherapy, all the patients achieved complete remission. With a median follow-up time of 44 months (range, 6-188), 3 patients (3.85%) relapsed within 3-26 months. Multivariate analysis showed that tumor size was the independent risk factor of recurrence and the cutoff value was 4.2cm. Among 37 patients who attempted to conceive, 31 achieved clinical pregnancy. The rate of pregnancy and live birth were 83.8% and 77.4%. Uterine rupture did not occurred no matter in cesarean section or vaginal delivery. No congenital abnormalities were reported among the live births.
  
  
  METHODS
  From January 1995 to December 2014, 78 patients with gestational trophoblastic neoplasias who underwent fertility-sparing uterine lesion resection at Peking Union Medical College Hospital were reviewed. The complete remission rate, fertility rate, pregnant outcomes and risk factors of recurrence were analyzed.
  
  
  CONCLUSIONS
  Fertility-sparing uterine lesion resection might be considered as a safe and reasonable alternative for high-selected young women to remove uterine lesion in the treatment of gestational trophoblastic neoplasias.
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China.
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR 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 and Peking Union Medical College, Beijing, PR China.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China.
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 and Peking Union Medical College, Beijing, PR 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 and Peking Union Medical College, Beijing, PR 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 and Peking Union Medical College, Beijing, PR China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Xiang
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005298:Fertility; D005500:Follow-Up Studies; D031901:Gestational Trophoblastic Disease / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D006801:Humans; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D012008:Recurrence; D014599:Uterus / Q000473:pathology* / Q000601:surgery; D055815:Young Adult
keywords: fertility-sparing surgery; gestational trophoblastic neoplasias; pregnant outcomes; prognostic factor; uterine lesion resection