Morbidity, mortality, and prognostic factors in gestational trophoblastic neoplasia with liver metastasis

医学 转移 内科学 相伴的 化疗 胃肠病学 存活率 单变量分析 肿瘤科 比例危险模型 多元分析 癌症
作者
D. Raffin,Pierre Descargues,Touria Hajri,Jérôme Massardier,Benoît You,Jean‐Pierre Lotz,Pascal Rousset,Jérémie Tordo,Mojgan Devouassoux‐Shisheboran,François Golfier,Pierre‐Adrien Bolze
出处
期刊:Journal of gynecology obstetrics and human reproduction [Elsevier BV]
卷期号:52 (8): 102636-102636
标识
DOI:10.1016/j.jogoh.2023.102636
摘要

Liver metastases of gestational trophoblastic neoplasia (GTN) are rare, but associated with poor prognosis. The additional concomitant presence of brain or intra-abdominal metastases, with liver metastases has been described as worsening factors, but the literature on this topic is reduced.To estimate the overall mortality, specific hepatic morbidity, and mortality, and to identify prognostic factors for patients with GTN and liver metastases.The medical records of 26 GTN patients with liver metastases registered in the French Center for Trophoblastic Diseases and treated between November 1999 and December 2019 were reviewed. Overall survival was described using Kaplan-Meier estimates. Prognostic factors were identified using univariate and multivariate Cox analyses.The 5-year overall survival rate was 60.7% for all patients with liver metastasis. The survival rate was higher in patients who achieved complete remission after first-line chemotherapy than in those who did not (100% vs 20%, p = 0.001). The only factor independently associated with prognosis was the presence of 6 or more liver metastases (5-year survival, 16.7% vs. 82.4% otherwise; HR =11.1, 95%CI, 2.3-53.1; p = 0.003). None of the five patients with a single liver metastasis died.GTN with liver metastasis is very rare (1.6%). The prognosis of patients seems to be improving. The results of this study are also reassuring for patients with complete remission after first-line combination chemotherapy, as well as for those with a single liver metastasis.
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