Gestational trophoblastic neoplasia natural history, complications and prognosis: Difference between revisions
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==Prognosis== | ==Prognosis== | ||
* The prognosis for cure of patients with GTDs is good even when the disease has spread to distant organs, especially when only the [[lungs]] are involved.<ref name="abc">General Information About Gestational Trophoblastic Disease. National Cancer Institute. http://www.cancer.gov/types/gestational-trophoblastic/hp/gtd-treatment-pdq Accessed on October 14, 2015</ref> | * The prognosis for cure of patients with GTDs is good even when the disease has spread to distant organs, especially when only the [[lungs]] are involved.<ref name="abc">General Information About Gestational Trophoblastic Disease. National Cancer Institute. http://www.cancer.gov/types/gestational-trophoblastic/hp/gtd-treatment-pdq Accessed on October 14, 2015</ref> <ref name="pmid9475153">{{cite journal |vauthors=Rodabaugh KJ, Bernstein MR, Goldstein DP, Berkowitz RS |title=Natural history of postterm choriocarcinoma |journal=J Reprod Med |volume=43 |issue=1 |pages=75–80 |date=January 1998 |pmid=9475153 |doi= |url=}}</ref> | ||
* The probability of cure depends on the following: | * The probability of cure depends on the following: | ||
:* [[Histologic]] type (invasive mole or choriocarcinoma) | :* [[Histologic]] type (invasive mole or choriocarcinoma) |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [2]
Overview
Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as good.[1]
Natural history
- For choriocarcinoma, the average age of presentation is 33 years for Asian women and 28 years for American women. A history of multiple pregnancies (or molar pregnancy) carries an increased risk for the development of choriocarcinoma.
- Patient has early symptoms such as vaginal bleeding, passing of tissue resembling a “bunch of grapes” from the vagina, the abdomen may grow at a much faster rate than with a normal pregnancy
- Nausea and vomiting, and absent fetal movement during pregnancy.
- As the tumor grows larger, patient may notice symptoms like lump in the vagina, hemoptysis, chest pain, trouble breathing, headache, dizziness, jaundice, paralysis, seizure, dysarthria, and dysphasia.
Prognosis
- The prognosis for cure of patients with GTDs is good even when the disease has spread to distant organs, especially when only the lungs are involved.[1] [2]
- The probability of cure depends on the following:
- Histologic type (invasive mole or choriocarcinoma)
- Extent of spread of the disease/largest tumor size
- Level of serum beta-hCG
- Duration of disease from the initial pregnancy event to start of treatment
- Number and specific sites of metastasis
- Nature of antecedent pregnancy
- Extent of prior treatment
- Disease duration greater than four months from delivery, pretreatment hCG level > 100,000 mIU/mL, presence of liver or brain metastases, and a WHO score > 8 were all important predictors of outcome in patients with postterm choriocarcinoma
Complications
Gestational trophoblastic neoplasia maybe associated with the following complications:[3]
- Metastasis
- Recurrent pregnancy loss
- Hemoptysis
- Pneumothorax
- Anemia
- Hyperthyroidism
- Pre-eclampsia
References
- ↑ 1.0 1.1 General Information About Gestational Trophoblastic Disease. National Cancer Institute. http://www.cancer.gov/types/gestational-trophoblastic/hp/gtd-treatment-pdq Accessed on October 14, 2015
- ↑ Rodabaugh KJ, Bernstein MR, Goldstein DP, Berkowitz RS (January 1998). "Natural history of postterm choriocarcinoma". J Reprod Med. 43 (1): 75–80. PMID 9475153.
- ↑ Zhang W, Liu B, Wu J, Sun B (April 2017). "Hemoptysis as primary manifestation in three women with choriocarcinoma with pulmonary metastasis: a case series". J Med Case Rep. 11 (1): 110. doi:10.1186/s13256-017-1256-9. PMID 28411623.