Gestational Trophoblastic Neoplasia Follow-up

1. Yingna S, Yang X, Xiuyu Y, et al. Clinical characteristics and treatment of gestational trophoblastic tumor with vaginal metastasis. Gynecol Oncol. 2002 Mar. 84(3):416-9. [QxMD MEDLINE Link].

2. Grumbine FC, Rosenshein NB, Brereton HD, et al. Management of liver metastasis from gestational trophoblastic neoplasia. Am J Obstet Gynecol. 1980 Aug 15. 137(8):959-61. [QxMD MEDLINE Link].

3. Soper JT, Mutch DG, Chin N, et al. Renal metastases of gestational trophoblastic disease: a report of eight cases. Obstet Gynecol. 1988 Nov. 72(5):796-8. [QxMD MEDLINE Link].

4. Smith HO, Kohorn E, Cole LA. Choriocarcinoma and gestational trophoblastic disease. Obstet Gynecol Clin North Am. 2005 Dec. 32(4):661-84. [QxMD MEDLINE Link].

5. Kohorn EI. Negotiating a staging and risk factor scoring system for gestational trophoblastic neoplasia. A progress report. J Reprod Med. 2002 Jun. 47(6):445-50. [QxMD MEDLINE Link].

6. Soper JT, Clarke-Pearson DL, Berchuck A, et al. 5-day methotrexate for women with metastatic gestational trophoblastic disease. Gynecol Oncol. 1994 Jul. 54(1):76-9. [QxMD MEDLINE Link].

7. Foulmann K, Guastalla JP, Caminet N, et al. What is the best protocol of single-agent methotrexate chemotherapy in nonmetastatic or low-risk metastatic gestational trophoblastic tumors? A review of the evidence. Gynecol Oncol. 2006 Jul. 102(1):103-10. [QxMD MEDLINE Link].

8. Roberts JP, Lurain JR. Treatment of low-risk metastatic gestational trophoblastic tumors with single-agent chemotherapy. Am J Obstet Gynecol. 1996 Jun. 174(6):1917-23; discussion 1923-4. [QxMD MEDLINE Link].

9. Matsui H, Suzuka K, Yamazawa K, et al. Relapse rate of patients with low-risk gestational trophoblastic tumor initially treated with single-agent chemotherapy. Gynecol Oncol. 2005 Mar. 96(3):616-20. [QxMD MEDLINE Link].

10. Kohorn EI. Is lack of response to single-agent chemotherapy in gestational trophoblastic disease associated with dose scheduling or chemotherapy resistance?. Gynecol Oncol. 2002 Apr. 85(1):36-9. [QxMD MEDLINE Link].

11. Homesley HD, Blessing JA, Schlaerth J, et al. Rapid escalation of weekly intramuscular methotrexate for nonmetastatic gestational trophoblastic disease: a Gynecologic Oncology Group study. Gynecol Oncol. 1990 Dec. 39(3):305-8. [QxMD MEDLINE Link].

12. Ngan HY, Odicino F, Maisonneuve P, Creasman WT, Beller U, Quinn MA, et al. Gestational trophoblastic neoplasia. FIGO 6th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet. 2006 Nov. 95 Suppl 1:S193-203. [QxMD MEDLINE Link].

13. Lurain JR. Advances in management of high-risk gestational trophoblastic tumors. J Reprod Med. 2002 Jun. 47(6):451-9. [QxMD MEDLINE Link].

14. Lurain JR, Singh DK, Schink JC. Primary treatment of metastatic high-risk gestational trophoblastic neoplasia with EMA-CO chemotherapy. J Reprod Med. 2006 Oct. 51(10):767-72. [QxMD MEDLINE Link].

15. Lehman E, Gershenson DM, Burke TW, et al. Salvage surgery for chemorefractory gestational trophoblastic disease. J Clin Oncol. 1994 Dec. 12(12):2737-42. [QxMD MEDLINE Link].

16. Escobar PF, Lurain JR, Singh DK, et al. Treatment of high-risk gestational trophoblastic neoplasia with etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine chemotherapy. Gynecol Oncol. 2003 Dec. 91(3):552-7. [QxMD MEDLINE Link].

17. Xiang Y, Sun Z, Wan X, et al. EMA/EP chemotherapy for chemorefractory gestational trophoblastic tumor. J Reprod Med. 2004 Jun. 49(6):443-6. [QxMD MEDLINE Link].

18. Barnard DE, Woodward KT, Yancy SG, et al. Hepatic metastases of choriocarcinoma: a report of 15 patients. Gynecol Oncol. 1986 Sep. 25(1):73-83. [QxMD MEDLINE Link].

19. Yordan EL Jr, Schlaerth J, Gaddis O, et al. Radiation therapy in the management of gestational choriocarcinoma metastatic to the central nervous system. Obstet Gynecol. 1987 Apr. 69(4):627-30. [QxMD MEDLINE Link].

20. Cagayan MS, Lu-Lasala LR. Management of gestational trophoblastic neoplasia with metastasis to the central nervous system: A 12-year review at the Philippine General Hospital. J Reprod Med. 2006 Oct. 51(10):785-92. [QxMD MEDLINE Link].

21. Schechter NR, Mychalczak B, Jones W, et al. Prognosis of patients treated with whole-brain radiation therapy for metastatic gestational trophoblastic disease. Gynecol Oncol. 1998 Feb. 68(2):183-92. [QxMD MEDLINE Link].

22. Soper JT, Spillman M, Sampson JH, et al. High-risk gestational trophoblastic neoplasia with brain metastases: individualized multidisciplinary therapy in the management of four patients. Gynecol Oncol. 2007 Mar. 104(3):691-4. [QxMD MEDLINE Link].

23. Rojas-Espaillat L, Houck KL, Hernandez E, et al. Fertility-sparing surgery for persistent gestational trophoblastic neoplasia in the myometrium: a case report. J Reprod Med. 2007 May. 52(5):431-4. [QxMD MEDLINE Link].

24. Jones WB, Romain K, Erlandson RA, et al. Thoracotomy in the management of gestational choriocarcinoma. A clinicopathologic study. Cancer. 1993 Oct 1. 72(7):2175-81. [QxMD MEDLINE Link].

25. Carlson N, Winter WE 3rd, Krivak TC, et al. Successful management of metastatic placental site trophoblastic tumor with multiple pulmonary resections. Gynecol Oncol. 2002 Oct. 87(1):146-9. [QxMD MEDLINE Link].

26. Hammond CB, Weed JC Jr, Currie JL. The role of operation in the current therapy of gestational trophoblastic disease. Am J Obstet Gynecol. 1980 Apr 1. 136(7):844-58. [QxMD MEDLINE Link].

27. Suzuka K, Matsui H, Iitsuka Y, et al. Adjuvant hysterectomy in low-risk gestational trophoblastic disease. Obstet Gynecol. 2001 Mar. 97(3):431-4. [QxMD MEDLINE Link].

28. van Trommel NE, Massuger LF, Verheijen RH, et al. The curative effect of a second curettage in persistent trophoblastic disease: a retrospective cohort survey. Gynecol Oncol. 2005 Oct. 99(1):6-13. [QxMD MEDLINE Link].

29. Berkowitz BJ, Jones JG, Merkatz IR, et al. Ovarian conservation in placental site trophoblastic tumor. Gynecol Oncol. 1990 May. 37(2):239-43. [QxMD MEDLINE Link].

30. Soper JT. Gestational trophoblastic disease. Obstet Gynecol. 2006 Jul. 108(1):176-87. [QxMD MEDLINE Link].

31. Agarwal R, Teoh S, Short D, et al. Chemotherapy and human chorionic gonadotropin concentrations 6 months after uterine evacuation of molar pregnancy: a retrospective cohort study. Lancet. 2012 Jan 14. 379(9811):130-5. [QxMD MEDLINE Link].

32. Yuen BH, Cannon W. Molar pregnancy in British Columbia: estimated incidence and postevacuation regression patterns of the beta subunit of human chorionic gonadotropin. Am J Obstet Gynecol. 1981 Feb 1. 139(3):316-9. [QxMD MEDLINE Link].

33. Goto S, Yamada A, Ishizuka T, et al. Development of postmolar trophoblastic disease after partial molar pregnancy. Gynecol Oncol. 1993 Feb. 48(2):165-70. [QxMD MEDLINE Link].

34. Hancock BW, Tidy JA. Current management of molar pregnancy. J Reprod Med. 2002 May. 47(5):347-54. [QxMD MEDLINE Link].

35. Watson EJ, Hernandez E, Miyazawa K. Partial hydatidiform moles: a review. Obstet Gynecol Surv. 1987 Sep. 42(9):540-4. [QxMD MEDLINE Link].

36. Cheung AN, Khoo US, Lai CY, et al. Metastatic trophoblastic disease after an initial diagnosis of partial hydatidiform mole: genotyping and chromosome in situ hybridization analysis. Cancer. 2004 Apr 1. 100(7):1411-7. [QxMD MEDLINE Link].

37. Menczer J, Girtler O, Zajdel L, et al. Metastatic trophoblastic disease following partial hydatidiform mole: case report and literature review. Gynecol Oncol. 1999 Aug. 74(2):304-7. [QxMD MEDLINE Link].

38. Lurain JR, Sand PK, Brewer JI. Choriocarcinoma associated with ectopic pregnancy. Obstet Gynecol. 1986 Aug. 68(2):286-7. [QxMD MEDLINE Link].

39. Horowitz NS, Goldstein DP, Berkowitz RS. Placental site trophoblastic tumors and epithelioid trophoblastic tumors: Biology, natural history, and treatment modalities. Gynecol Oncol. 2017 Jan. 144 (1):208-214. [QxMD MEDLINE Link].

40. Tsuji Y, Tsubamoto H, Hori M, et al. Case of PSTT treated with chemotherapy followed by open uterine tumor resection to preserve fertility. Gynecol Oncol. 2002 Dec. 87(3):303-7. [QxMD MEDLINE Link].

41. Nigam S, Singhal N, Kumar Gupta S, et al. Placental site trophoblastic tumor in a postmenopausal female--a case report. Gynecol Oncol. 2004 May. 93(2):550-3. [QxMD MEDLINE Link].

42. Hassadia A, Gillespie A, Tidy J, et al. Placental site trophoblastic tumour: clinical features and management. Gynecol Oncol. 2005 Dec. 99(3):603-7. [QxMD MEDLINE Link].

43. Zhao J, Xiang Y, Wan XR, et al. Clinical and pathologic characteristics and prognosis of placental site trophoblastic tumor. J Reprod Med. 2006 Dec. 51(12):939-44. [QxMD MEDLINE Link].

44. Papadopoulos AJ, Foskett M, Seckl MJ, et al. Twenty-five years' clinical experience with placental site trophoblastic tumors. J Reprod Med. 2002 Jun. 47(6):460-4. [QxMD MEDLINE Link].

45. Grimes DA. Epidemiology of gestational trophoblastic disease. Am J Obstet Gynecol. 1984 Oct 1. 150(3):309-18. [QxMD MEDLINE Link].

46. McDonald TW, Ruffolo EH. Modern management of gestational trophoblastic disease. Obstet Gynecol Surv. 1983 Feb. 38(2):67-83. [QxMD MEDLINE Link].

47. Palmer JR. Advances in the epidemiology of gestational trophoblastic disease. J Reprod Med. 1994 Mar. 39(3):155-62. [QxMD MEDLINE Link].

48. Chakrabarti BK, Mondal NR, Chatterjee T. Gestational trophoblastic tumor at a tertiary level cancer center: a retrospective study. J Reprod Med. 2006 Nov. 51(11):875-8. [QxMD MEDLINE Link].

49. Smith HO, Qualls CR, Prairie BA, et al. Trends in gestational choriocarcinoma: a 27-year perspective. Obstet Gynecol. 2003 Nov. 102(5 Pt 1):978-87. [QxMD MEDLINE Link].

50. Seckl MJ, Sebire NJ, Fisher RA, et al. Gestational trophoblastic disease: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013 Sep 1. [QxMD MEDLINE Link].

51. Soper JT, Evans AC, Conaway MR, et al. Evaluation of prognostic factors and staging in gestational trophoblastic tumor. Obstet Gynecol. 1994 Dec. 84(6):969-73. [QxMD MEDLINE Link].

52. Macdonald MC, Hancock BW, Winter MC, Coleman RE, Tidy JA. Management and outcomes of patients with stage I and III low-risk gestational trophoblastic neoplasia treated in Sheffield, UK, from 1997-2006. J Reprod Med. 2016. 61:341-346.

53. Agarwal R, Alifrangis C, Everard J, Savage PM, Short D, Tidy J, et al. Management and survival of patients with FIGO high-risk gestational trophoblastic neoplasia: the U.K. experience, 1995-2010. J Reprod Med. 2014 Jan-Feb. 59 (1-2):7-12. [QxMD MEDLINE Link].

54. Cagayan MS. High-risk metastatic gestational trophoblastic neoplasia. Primary management with EMA-CO (etoposide, methotrexate, actinomycin D, cyclophosphamide and vincristine) chemotherapy. J Reprod Med. 2012 May-Jun. 57 (5-6):231-6. [QxMD MEDLINE Link].

55. Kong Y, Yang J, Jiang F, Zhao J, Ren T, Li J, et al. Clinical characteristics and prognosis of ultra high-risk gestational trophoblastic neoplasia patients: A retrospective cohort study. Gynecol Oncol. 2017 Jul. 146 (1):81-86. [QxMD MEDLINE Link].

56. Mutch DG, Soper JT, Babcock CJ, et al. Recurrent gestational trophoblastic disease. Experience of the Southeastern Regional Trophoblastic Disease Center. Cancer. 1990 Sep 1. 66(5):978-82. [QxMD MEDLINE Link].

57. Rustin GJ, Newlands ES, Lutz JM, et al. Combination but not single-agent methotrexate chemotherapy for gestational trophoblastic tumors increases the incidence of second tumors. J Clin Oncol. 1996 Oct. 14(10):2769-73. [QxMD MEDLINE Link].

58. Matsui H, Iitsuka Y, Suzuka K, et al. Risk of abnormal pregnancy completing chemotherapy for gestational trophoblastic tumor. Gynecol Oncol. 2003 Feb. 88(2):104-7. [QxMD MEDLINE Link].

59. Braga A, Torres B, Burlá M, Maestá I, Sun SY, Lin L, et al. Is chemotherapy necessary for patients with molar pregnancy and human chorionic gonadotropin serum levels raised but falling at 6months after uterine evacuation?. Gynecol Oncol. 2016 Dec. 143 (3):558-564. [QxMD MEDLINE Link].

60. Fulop V, Mok SC, Berkowitz RS. Molecular biology of gestational trophoblastic neoplasia: a review. J Reprod Med. 2004 Jun. 49(6):415-22. [QxMD MEDLINE Link].

61. Fong PY, Xue WC, Ngan HY, et al. Mcl-1 expression in gestational trophoblastic disease correlates with clinical outcome: a differential expression study. Cancer. 2005 Jan 15. 103(2):268-76. [QxMD MEDLINE Link].

62. Kim SJ, Park SE, Lee C, et al. Altered imprinting, promoter usage, and expression of insulin-like growth factor-II gene in gestational trophoblastic diseases. Gynecol Oncol. 2003 Mar. 88(3):411-8. [QxMD MEDLINE Link].

63. Olsen TG, Barnes AA, King JA. Elevated HCG outside of pregnancy--diagnostic considerations and laboratory evaluation. Obstet Gynecol Surv. 2007 Oct. 62(10):669-74; quiz 691. [QxMD MEDLINE Link].

64. Olsen TG, Hubert PR, Nycum LR. Falsely elevated human chorionic gonadotropin leading to unnecessary therapy. Obstet Gynecol. 2001 Nov. 98(5 Pt 1):843-5. [QxMD MEDLINE Link].

65. Khanlian SA, Cole LA. Management of gestational trophoblastic disease and other cases with low serum levels of human chorionic gonadotropin. J Reprod Med. 2006 Oct. 51(10):812-8. [QxMD MEDLINE Link].

66. Matsui H, Iitsuka Y, Suzuka K, et al. Salvage chemotherapy for high-risk gestational trophoblastic tumor. J Reprod Med. 2004 Jun. 49(6):438-42. [QxMD MEDLINE Link].

67. Knox S, Brooks SE, Wong-You-Cheong J, et al. Choriocarcinoma and epithelial trophoblastic tumor: successful treatment of relapse with hysterectomy and high-dose chemotherapy with peripheral stem cell support: a case report. Gynecol Oncol. 2002 Apr. 85(1):204-8. [QxMD MEDLINE Link].

68. Ngan HY, Chan FL, Au VW, et al. Clinical outcome of micrometastasis in the lung in stage IA persistent gestational trophoblastic disease. Gynecol Oncol. 1998 Aug. 70(2):192-4. [QxMD MEDLINE Link].

69. Gamer EI, Garrett A, Goldstein DP, et al. Significance of chest computed tomography findings in the evaluation and treatment of persistent gestational trophoblastic neoplasia. J Reprod Med. 2004 Jun. 49(6):411-4. [QxMD MEDLINE Link].

70. Brown J, Naumann RW, Seckl MJ, Schink J. 15years of progress in gestational trophoblastic disease: Scoring, standardization, and salvage. Gynecol Oncol. 2017 Jan. 144 (1):200-207. [QxMD MEDLINE Link].

71. Osborne RJ, Filiaci VL, Schink JC, Mannel RS, Behbakht K, Hoffman JS, et al. Second Curettage for Low-Risk Nonmetastatic Gestational Trophoblastic Neoplasia. Obstet Gynecol. 2016 Sep. 128 (3):535-42. [QxMD MEDLINE Link].

72. Fukunaga M. Immunohistochemical characterization of p57(KIP2) expression in early hydatidiform moles. Hum Pathol. 2002 Dec. 33(12):1188-92. [QxMD MEDLINE Link].

73. FIGO staging for gestational trophoblastic neoplasia 2000. FIGO Oncology Committee. Int J Gynaecol Obstet. 2002 Jun. 77(3):285-7. [QxMD MEDLINE Link].

74. Boggs W. New Guideline for Gestational Trophoblastic Disease. Available at http://www.medscape.com/viewarticle/811689. Accessed: September 30, 2013.

75. Kashimura Y, Kashimura M, Sugimori H, et al. Prophylactic chemotherapy for hydatidiform mole. Five to 15 years follow-up. Cancer. 1986 Aug 1. 58(3):624-9. [QxMD MEDLINE Link].

76. Massad LS, Abu-Rustum NR, Lee SS, et al. Poor compliance with postmolar surveillance and treatment protocols by indigent women. Obstet Gynecol. 2000 Dec. 96(6):940-4. [QxMD MEDLINE Link].

77. Osborne R, Filiaci V, Schink J, et al. A randomized phase III trial comparing weekly parenteral methotrexate and "pulsed" dactinomycin as primary management for low-risk gestational trophoblastic neoplasia: A Gynecologic Oncology Group study. Gynecol Oncol. 2008. 108:S2-S3.

78. Schink JC, Filiaci V, Huang HQ, et al. An international randomized phase III trial of pulse actinomycin-D versus multi-day methotrexate for the treatment of low risk gestational trophoblastic neoplasia; NRG/GOG 275. Gynecol Oncol. 2020 Aug. 158 (2):354-60. [QxMD MEDLINE Link].

79. Woolas RP, Bower M, Newlands ES, et al. Influence of chemotherapy for gestational trophoblastic disease on subsequent pregnancy outcome. Br J Obstet Gynaecol. 1998 Sep. 105(9):1032-5. [QxMD MEDLINE Link].

80. Lok CA, van der Houwen C, ten Kate-Booij MJ, et al. Pregnancy after EMA/CO for gestational trophoblastic disease: a report from The Netherlands. BJOG. 2003 Jun. 110(6):560-6. [QxMD MEDLINE Link].

Enrique Hernandez, MD, FACOG, FACS Chairman, Department of Obstetrics and Gynecology, J Robert Willson Professor of Obstetrics, Gynecology and Reproductive Science, Professor of Pathology, Temple University Hospital, Lewis Katz School of Medicine at Temple University

Enrique Hernandez, MD, FACOG, FACS is a member of the following medical societies: Alpha Omega Alpha, American Cancer Society, American College of Obstetricians and Gynecologists, American College of Surgeons, American Gynecological and Obstetrical Society, American Medical Association, American Society for Colposcopy and Cervical Pathology, Association of Professors of Gynecology and Obstetrics, Johns Hopkins Medical and Surgical Association, Pennsylvania Medical Society, Philadelphia County Medical Society, Society of Gynecologic Oncology

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Jori S Carter, MD, MS Gynecologic Oncologist, Women's Cancer and Wellness Institute

Jori S Carter, MD, MS is a member of the following medical societies: Alpha Omega Alpha, American College of Obstetricians and Gynecologists, American Society of Clinical Oncology, Association of Women Surgeons, International Society for Magnetic Resonance in Medicine, Society of Gynecologic Oncology

Disclosure: Nothing to disclose.

Leslie M Randall, MD, MAS, FACS Professor and Director, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Diane Harris Wright Professor of Gynecologic Oncology Research, Massey Cancer Center, Virginia Commonwealth University School of Medicine

Leslie M Randall, MD, MAS, FACS is a member of the following medical societies: Academy for Innovation in Medical Education, American College of Surgeons, American Medical Association, American Society of Clinical Oncology, International Gynecologic Cancer Society, Society of Gynecologic Oncology

Disclosure: Nothing to disclose.

Robert C Shepard, MD, FACP Associate Professor of Medicine in Hematology and Oncology at University of North Carolina at Chapel Hill; Vice President of Scientific Affairs, Therapeutic Expertise, Oncology, at PRA International

Robert C Shepard, MD, FACP is a member of the following medical societies: American Association for Cancer Research, American Association for Physician Leadership, European Society for Medical Oncology, Association of Clinical Research Professionals, American Federation for Clinical Research, Eastern Cooperative Oncology Group, Society for Immunotherapy of Cancer, American Medical Informatics Association, American College of Physicians, American Federation for Medical Research, American Medical Association, American Society of Hematology, Massachusetts Medical Society

Disclosure: Nothing to disclose.

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