Clinicopathological characteristics and oncologic outcomes of patients with gestational trophoblastic neoplasia manifesting as isolated pulmonary lesions
To elucidate the clinicopathological characteristics and oncological outcomes of a special group of patients with gestational trophoblastic neoplasia (GTN) initially presenting with isolated lung lesions, elevated human chorionic gonadotropin (hCG) levels, and unobserved pelvic lesions. Overall, 235...
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| Veröffentlicht in: | Gynecologic oncology 2024-11, Vol.190, p.28-34 |
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| creator | Gu, Yu Liu, Yang Cheng, Hongyan Wang, Wenze Xue, Xiaowei Wan, Xirun Feng, Fengzhi Yang, Junjun Ren, Tong Zhao, Jun Jiang, Fang Li, Yuan Xiang, Yang |
| description | To elucidate the clinicopathological characteristics and oncological outcomes of a special group of patients with gestational trophoblastic neoplasia (GTN) initially presenting with isolated lung lesions, elevated human chorionic gonadotropin (hCG) levels, and unobserved pelvic lesions.
Overall, 2358 patients with GTN treated at our hospital between 2000 and 2023 were retrospectively reviewed, and 40 patients were evaluated. The demographic characteristics, clinicopathological features, treatment data, and follow-up information of each patient were collected. The primary outcome was progression free survival. Kaplan-Meier analysis and univariate and multivariate Cox proportional hazard analyses were used to identify the risk factors.
Among the 40 patients, 95.0 % had solitary lung lesions, with a median size of 1.9 cm. Moreover, 72.5 % of patients were pathologically confirmed as epithelioid trophoblastic tumors (ETT). During a median follow-up period of 53.5 months (range, 2–143), 11 patients experienced recurrence, including all patients who received chemotherapy alone as the initial treatment, and no death was observed. Relapse treatment involved lung segmentectomy and lobectomy combined with chemotherapy and immunotherapy. Univariate and multivariate Cox analyses identified comparing with surgery±chemotherapy, chemotherapy alone as the initial treatment (hazard ratio [HR] =7.738, 95 % confidence interval [CI] 1.698–35.269, P = 0.008) as independent risk factor for recurrence.
In patients with a history of pregnancy exhibiting isolated pulmonary lesions, elevated hCG levels (mostly |
| doi_str_mv | 10.1016/j.ygyno.2024.07.686 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3092009253</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0090825824010503</els_id><sourcerecordid>3092009253</sourcerecordid><originalsourceid>FETCH-LOGICAL-c239t-6af164677374fa652740e2fb9c8e76819c81b1b9d4957328a753521c7b0f2fd53</originalsourceid><addsrcrecordid>eNp9UcuOFCEUJUbjtKNfYGJYuqmSRwHFwoXp-JhkEje6JhQF3XQoKIHS9Kf4t9L26HJW9-ZyzrmHewB4jVGPEebvTv35cI6pJ4gMPRI9H_kTsMNIso6PTD4FO4Qk6kbCxhvwopQTQogiTJ6DGyoxGSkdd-D3PvjoTVp1PaaQDt7oAM1RZ22qzb5UbwrUcYYpmus7TFs1abEFJgcbzdtYC_zl6xEebKltkGLTqDmtxzQFfZGA0aa1tV7DRUfvGs7HA9QF-pKCrnaG6xaWRsxnGGxpEuUleOZ0KPbVQ70F3z99_Lb_0t1__Xy3_3DfGUJl7bh2mA9cCCoGpzkjYkCWuEma0Qo-4lbxhCc5D5IJSkYtGGUEGzEhR9zM6C14e9Vdc_qxNWdq8cXYEHQzvRVFkSTtkITRBqVXqMmplGydWrNfmmeFkbpkok7qbybqkolCQrVMGuvNw4JtWuz8n_MvhAZ4fwXY9s2f3mZVTLuqsbPP1lQ1J__ogj-g76Od</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3092009253</pqid></control><display><type>article</type><title>Clinicopathological characteristics and oncologic outcomes of patients with gestational trophoblastic neoplasia manifesting as isolated pulmonary lesions</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Gu, Yu ; Liu, Yang ; Cheng, Hongyan ; Wang, Wenze ; Xue, Xiaowei ; Wan, Xirun ; Feng, Fengzhi ; Yang, Junjun ; Ren, Tong ; Zhao, Jun ; Jiang, Fang ; Li, Yuan ; Xiang, Yang</creator><creatorcontrib>Gu, Yu ; Liu, Yang ; Cheng, Hongyan ; Wang, Wenze ; Xue, Xiaowei ; Wan, Xirun ; Feng, Fengzhi ; Yang, Junjun ; Ren, Tong ; Zhao, Jun ; Jiang, Fang ; Li, Yuan ; Xiang, Yang</creatorcontrib><description>To elucidate the clinicopathological characteristics and oncological outcomes of a special group of patients with gestational trophoblastic neoplasia (GTN) initially presenting with isolated lung lesions, elevated human chorionic gonadotropin (hCG) levels, and unobserved pelvic lesions.
Overall, 2358 patients with GTN treated at our hospital between 2000 and 2023 were retrospectively reviewed, and 40 patients were evaluated. The demographic characteristics, clinicopathological features, treatment data, and follow-up information of each patient were collected. The primary outcome was progression free survival. Kaplan-Meier analysis and univariate and multivariate Cox proportional hazard analyses were used to identify the risk factors.
Among the 40 patients, 95.0 % had solitary lung lesions, with a median size of 1.9 cm. Moreover, 72.5 % of patients were pathologically confirmed as epithelioid trophoblastic tumors (ETT). During a median follow-up period of 53.5 months (range, 2–143), 11 patients experienced recurrence, including all patients who received chemotherapy alone as the initial treatment, and no death was observed. Relapse treatment involved lung segmentectomy and lobectomy combined with chemotherapy and immunotherapy. Univariate and multivariate Cox analyses identified comparing with surgery±chemotherapy, chemotherapy alone as the initial treatment (hazard ratio [HR] =7.738, 95 % confidence interval [CI] 1.698–35.269, P = 0.008) as independent risk factor for recurrence.
In patients with a history of pregnancy exhibiting isolated pulmonary lesions, elevated hCG levels (mostly <1000 mIU/mL), and unobserved pelvic lesions, ETT should be considered first. Surgical resection of lung lesion is crucial for optimal management. When chemotherapy is considered, multidrug regimen is recommended.
•Gestational trophoblastic neoplasia (GTN) comprises a group of pregnancy-associated malignancies.•Most patients with isolated GTN of the lung had a pathological diagnosis of epithelial trophoblastic tumors (ETT).•Surgical resection of lung lesions is crucial, adjuvant and multidrug chemotherapy is recommended when needed.</description><identifier>ISSN: 0090-8258</identifier><identifier>ISSN: 1095-6859</identifier><identifier>EISSN: 1095-6859</identifier><identifier>DOI: 10.1016/j.ygyno.2024.07.686</identifier><identifier>PMID: 39128338</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Chorionic Gonadotropin - blood ; Diagnosis ; Epithelial trophoblastic tumor ; Female ; Gestational Trophoblastic Disease - drug therapy ; Gestational Trophoblastic Disease - pathology ; Gestational Trophoblastic Disease - therapy ; Gestational trophoblastic neoplasia ; Humans ; Lung Neoplasms - mortality ; Lung Neoplasms - pathology ; Lung Neoplasms - therapy ; Middle Aged ; Pregnancy ; Progression-Free Survival ; Pulmonary lesion ; Retrospective Studies ; Short tandem repeat genotyping ; Treatment ; Young Adult</subject><ispartof>Gynecologic oncology, 2024-11, Vol.190, p.28-34</ispartof><rights>2024 The Authors</rights><rights>Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c239t-6af164677374fa652740e2fb9c8e76819c81b1b9d4957328a753521c7b0f2fd53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0090825824010503$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39128338$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gu, Yu</creatorcontrib><creatorcontrib>Liu, Yang</creatorcontrib><creatorcontrib>Cheng, Hongyan</creatorcontrib><creatorcontrib>Wang, Wenze</creatorcontrib><creatorcontrib>Xue, Xiaowei</creatorcontrib><creatorcontrib>Wan, Xirun</creatorcontrib><creatorcontrib>Feng, Fengzhi</creatorcontrib><creatorcontrib>Yang, Junjun</creatorcontrib><creatorcontrib>Ren, Tong</creatorcontrib><creatorcontrib>Zhao, Jun</creatorcontrib><creatorcontrib>Jiang, Fang</creatorcontrib><creatorcontrib>Li, Yuan</creatorcontrib><creatorcontrib>Xiang, Yang</creatorcontrib><title>Clinicopathological characteristics and oncologic outcomes of patients with gestational trophoblastic neoplasia manifesting as isolated pulmonary lesions</title><title>Gynecologic oncology</title><addtitle>Gynecol Oncol</addtitle><description>To elucidate the clinicopathological characteristics and oncological outcomes of a special group of patients with gestational trophoblastic neoplasia (GTN) initially presenting with isolated lung lesions, elevated human chorionic gonadotropin (hCG) levels, and unobserved pelvic lesions.
Overall, 2358 patients with GTN treated at our hospital between 2000 and 2023 were retrospectively reviewed, and 40 patients were evaluated. The demographic characteristics, clinicopathological features, treatment data, and follow-up information of each patient were collected. The primary outcome was progression free survival. Kaplan-Meier analysis and univariate and multivariate Cox proportional hazard analyses were used to identify the risk factors.
Among the 40 patients, 95.0 % had solitary lung lesions, with a median size of 1.9 cm. Moreover, 72.5 % of patients were pathologically confirmed as epithelioid trophoblastic tumors (ETT). During a median follow-up period of 53.5 months (range, 2–143), 11 patients experienced recurrence, including all patients who received chemotherapy alone as the initial treatment, and no death was observed. Relapse treatment involved lung segmentectomy and lobectomy combined with chemotherapy and immunotherapy. Univariate and multivariate Cox analyses identified comparing with surgery±chemotherapy, chemotherapy alone as the initial treatment (hazard ratio [HR] =7.738, 95 % confidence interval [CI] 1.698–35.269, P = 0.008) as independent risk factor for recurrence.
In patients with a history of pregnancy exhibiting isolated pulmonary lesions, elevated hCG levels (mostly <1000 mIU/mL), and unobserved pelvic lesions, ETT should be considered first. Surgical resection of lung lesion is crucial for optimal management. When chemotherapy is considered, multidrug regimen is recommended.
•Gestational trophoblastic neoplasia (GTN) comprises a group of pregnancy-associated malignancies.•Most patients with isolated GTN of the lung had a pathological diagnosis of epithelial trophoblastic tumors (ETT).•Surgical resection of lung lesions is crucial, adjuvant and multidrug chemotherapy is recommended when needed.</description><subject>Adult</subject><subject>Chorionic Gonadotropin - blood</subject><subject>Diagnosis</subject><subject>Epithelial trophoblastic tumor</subject><subject>Female</subject><subject>Gestational Trophoblastic Disease - drug therapy</subject><subject>Gestational Trophoblastic Disease - pathology</subject><subject>Gestational Trophoblastic Disease - therapy</subject><subject>Gestational trophoblastic neoplasia</subject><subject>Humans</subject><subject>Lung Neoplasms - mortality</subject><subject>Lung Neoplasms - pathology</subject><subject>Lung Neoplasms - therapy</subject><subject>Middle Aged</subject><subject>Pregnancy</subject><subject>Progression-Free Survival</subject><subject>Pulmonary lesion</subject><subject>Retrospective Studies</subject><subject>Short tandem repeat genotyping</subject><subject>Treatment</subject><subject>Young Adult</subject><issn>0090-8258</issn><issn>1095-6859</issn><issn>1095-6859</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UcuOFCEUJUbjtKNfYGJYuqmSRwHFwoXp-JhkEje6JhQF3XQoKIHS9Kf4t9L26HJW9-ZyzrmHewB4jVGPEebvTv35cI6pJ4gMPRI9H_kTsMNIso6PTD4FO4Qk6kbCxhvwopQTQogiTJ6DGyoxGSkdd-D3PvjoTVp1PaaQDt7oAM1RZ22qzb5UbwrUcYYpmus7TFs1abEFJgcbzdtYC_zl6xEebKltkGLTqDmtxzQFfZGA0aa1tV7DRUfvGs7HA9QF-pKCrnaG6xaWRsxnGGxpEuUleOZ0KPbVQ70F3z99_Lb_0t1__Xy3_3DfGUJl7bh2mA9cCCoGpzkjYkCWuEma0Qo-4lbxhCc5D5IJSkYtGGUEGzEhR9zM6C14e9Vdc_qxNWdq8cXYEHQzvRVFkSTtkITRBqVXqMmplGydWrNfmmeFkbpkok7qbybqkolCQrVMGuvNw4JtWuz8n_MvhAZ4fwXY9s2f3mZVTLuqsbPP1lQ1J__ogj-g76Od</recordid><startdate>202411</startdate><enddate>202411</enddate><creator>Gu, Yu</creator><creator>Liu, Yang</creator><creator>Cheng, Hongyan</creator><creator>Wang, Wenze</creator><creator>Xue, Xiaowei</creator><creator>Wan, Xirun</creator><creator>Feng, Fengzhi</creator><creator>Yang, Junjun</creator><creator>Ren, Tong</creator><creator>Zhao, Jun</creator><creator>Jiang, Fang</creator><creator>Li, Yuan</creator><creator>Xiang, Yang</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202411</creationdate><title>Clinicopathological characteristics and oncologic outcomes of patients with gestational trophoblastic neoplasia manifesting as isolated pulmonary lesions</title><author>Gu, Yu ; Liu, Yang ; Cheng, Hongyan ; Wang, Wenze ; Xue, Xiaowei ; Wan, Xirun ; Feng, Fengzhi ; Yang, Junjun ; Ren, Tong ; Zhao, Jun ; Jiang, Fang ; Li, Yuan ; Xiang, Yang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c239t-6af164677374fa652740e2fb9c8e76819c81b1b9d4957328a753521c7b0f2fd53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Chorionic Gonadotropin - blood</topic><topic>Diagnosis</topic><topic>Epithelial trophoblastic tumor</topic><topic>Female</topic><topic>Gestational Trophoblastic Disease - drug therapy</topic><topic>Gestational Trophoblastic Disease - pathology</topic><topic>Gestational Trophoblastic Disease - therapy</topic><topic>Gestational trophoblastic neoplasia</topic><topic>Humans</topic><topic>Lung Neoplasms - mortality</topic><topic>Lung Neoplasms - pathology</topic><topic>Lung Neoplasms - therapy</topic><topic>Middle Aged</topic><topic>Pregnancy</topic><topic>Progression-Free Survival</topic><topic>Pulmonary lesion</topic><topic>Retrospective Studies</topic><topic>Short tandem repeat genotyping</topic><topic>Treatment</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gu, Yu</creatorcontrib><creatorcontrib>Liu, Yang</creatorcontrib><creatorcontrib>Cheng, Hongyan</creatorcontrib><creatorcontrib>Wang, Wenze</creatorcontrib><creatorcontrib>Xue, Xiaowei</creatorcontrib><creatorcontrib>Wan, Xirun</creatorcontrib><creatorcontrib>Feng, Fengzhi</creatorcontrib><creatorcontrib>Yang, Junjun</creatorcontrib><creatorcontrib>Ren, Tong</creatorcontrib><creatorcontrib>Zhao, Jun</creatorcontrib><creatorcontrib>Jiang, Fang</creatorcontrib><creatorcontrib>Li, Yuan</creatorcontrib><creatorcontrib>Xiang, Yang</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gynecologic oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gu, Yu</au><au>Liu, Yang</au><au>Cheng, Hongyan</au><au>Wang, Wenze</au><au>Xue, Xiaowei</au><au>Wan, Xirun</au><au>Feng, Fengzhi</au><au>Yang, Junjun</au><au>Ren, Tong</au><au>Zhao, Jun</au><au>Jiang, Fang</au><au>Li, Yuan</au><au>Xiang, Yang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinicopathological characteristics and oncologic outcomes of patients with gestational trophoblastic neoplasia manifesting as isolated pulmonary lesions</atitle><jtitle>Gynecologic oncology</jtitle><addtitle>Gynecol Oncol</addtitle><date>2024-11</date><risdate>2024</risdate><volume>190</volume><spage>28</spage><epage>34</epage><pages>28-34</pages><issn>0090-8258</issn><issn>1095-6859</issn><eissn>1095-6859</eissn><abstract>To elucidate the clinicopathological characteristics and oncological outcomes of a special group of patients with gestational trophoblastic neoplasia (GTN) initially presenting with isolated lung lesions, elevated human chorionic gonadotropin (hCG) levels, and unobserved pelvic lesions.
Overall, 2358 patients with GTN treated at our hospital between 2000 and 2023 were retrospectively reviewed, and 40 patients were evaluated. The demographic characteristics, clinicopathological features, treatment data, and follow-up information of each patient were collected. The primary outcome was progression free survival. Kaplan-Meier analysis and univariate and multivariate Cox proportional hazard analyses were used to identify the risk factors.
Among the 40 patients, 95.0 % had solitary lung lesions, with a median size of 1.9 cm. Moreover, 72.5 % of patients were pathologically confirmed as epithelioid trophoblastic tumors (ETT). During a median follow-up period of 53.5 months (range, 2–143), 11 patients experienced recurrence, including all patients who received chemotherapy alone as the initial treatment, and no death was observed. Relapse treatment involved lung segmentectomy and lobectomy combined with chemotherapy and immunotherapy. Univariate and multivariate Cox analyses identified comparing with surgery±chemotherapy, chemotherapy alone as the initial treatment (hazard ratio [HR] =7.738, 95 % confidence interval [CI] 1.698–35.269, P = 0.008) as independent risk factor for recurrence.
In patients with a history of pregnancy exhibiting isolated pulmonary lesions, elevated hCG levels (mostly <1000 mIU/mL), and unobserved pelvic lesions, ETT should be considered first. Surgical resection of lung lesion is crucial for optimal management. When chemotherapy is considered, multidrug regimen is recommended.
•Gestational trophoblastic neoplasia (GTN) comprises a group of pregnancy-associated malignancies.•Most patients with isolated GTN of the lung had a pathological diagnosis of epithelial trophoblastic tumors (ETT).•Surgical resection of lung lesions is crucial, adjuvant and multidrug chemotherapy is recommended when needed.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>39128338</pmid><doi>10.1016/j.ygyno.2024.07.686</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Chorionic Gonadotropin - blood Diagnosis Epithelial trophoblastic tumor Female Gestational Trophoblastic Disease - drug therapy Gestational Trophoblastic Disease - pathology Gestational Trophoblastic Disease - therapy Gestational trophoblastic neoplasia Humans Lung Neoplasms - mortality Lung Neoplasms - pathology Lung Neoplasms - therapy Middle Aged Pregnancy Progression-Free Survival Pulmonary lesion Retrospective Studies Short tandem repeat genotyping Treatment Young Adult |
| title | Clinicopathological characteristics and oncologic outcomes of patients with gestational trophoblastic neoplasia manifesting as isolated pulmonary lesions |
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