Challenges in the Treatment of Low-risk Gestational Trophoblastic Neoplasia - Revista Brasileira de Ginecologia e Obstetrícia

Challenges in the Treatment of Low-risk Gestational Trophoblastic Neoplasia |

Gestational trophoblastic neoplasia (GTN) is a rare tumor that arises from placental tissues and exhibits a high cure rate when treated with cytotoxic chemotherapy. Although its most common origin is hydatidiform mole, GTN can develop from any type of pregnancy: abortion, ectopic pregnancy, or preterm/term gestation.

The early diagnosis of GTN is the key to ensure cure as patients with late diagnosis often have metastatic disease and require more aggressive and toxic treatment and experience a worse prognosis. While GTN is highly sensitive to chemotherapy, it is important to differentiate which patients will respond to single-agent chemotherapy versus those that will require more morbid, multiagent regimens to achieve remission. To this end, the World Health Organization (WHO) and the International Federation of Gynecology and Obstetrics (FIGO) created a combined anatomical staging and clinical prognostic risk scoring system which identifies patients with a higher risk of resistance to single-agent chemotherapy. Patients with a WHO/FIGO risk score ≤ 6 are considered to have low-risk GTN and are treated with single-agent chemotherapy while those with a score ≥ 7 are classified as having high-risk GTN and are treated with multiagent chemotherapy.

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