Hancock B.W., Welch E.M., Gillespie A.M., Newlands E.S.
UK Trophoblastic Disease Screening and Treatment Centres, YCR Department of Clinical Oncology, Weston Park Hospital, Sheffield, and Department of Medical Oncology, Charing Cross Hospital, London, UK.
Int J Gynecol Cancer. 2000 Jul;10(4):318-322. doi: 10.1046/j.1525-1438.2000.010004318.x.
It is widely accepted that patients with persistent gestational trophoblastic disease (GTD) are best managed by stratifying their treatment according to recognized adverse prognostic features. We retrospectively evaluated 201 patients who had received chemotherapy for persistent low or high risk GTD at the Sheffield Center according to criteria used in established and proposed WHO scoring and FIGO staging systems to identify the numbers of patients in each risk category, the treatment they would receive, chemotherapy resistance patterns, and eventual outcome. The systems were broadly comparable and chemotherapy resistance was always greater in the high-risk groups (at least 33%), particularly when patients were divided into just two risk categories. Such a categorization led to fewer patients (less than 15%) falling into high-risk groupings, but outcome was not compromised. Mortality (3 deaths) was associated with high risk categorization in all systems evaluated. A proposal to combine revised FIGO staging and modified WHO scoring systems, with two risk groupings, is realistic and practicable.
人们普遍认为，持续性妊娠滋养细胞疾病（GTD）患者最好根据公认的不良预后特征进行分层治疗。我们回顾性评估了201例在谢菲尔德中心接受持续性低风险或高风险GTD化疗的患者，依据既定的和提议的世界卫生组织（WHO）评分及国际妇产科联盟（FIGO）分期系统所使用的标准，以确定每个风险类别中的患者数量、他们将接受的治疗、化疗耐药模式以及最终结局。这些系统大致可比，高风险组的化疗耐药性始终更高（至少33%），尤其是当患者仅分为两个风险类别时。这样的分类导致进入高风险组的患者较少（不到15%），但结局并未受到影响。在所有评估的系统中，死亡率（3例死亡）与高风险分类相关。将修订后的FIGO分期和改良的WHO评分系统结合起来，分为两个风险组的提议是现实可行的。
