[Diagnosis and management of gestational trophoblastic tumor with liver metastases].

OBJECTIVE

To evaluate management options and clinical prognosis for women presenting gestational trophoblastic tumor (GTT) with liver metastases.

METHODS

We retrospectively analyzed sixteen GTT patients with liver metastases treated in the Peking Union Medical College (PUMC) hospital from 1985 to 1998. All were treated with 5-FU combined chemotherapy or EMA/CO regimen. Eight of them received hepatic artery infusion chemotherapy. Treatment outcome was measured by beta subunit human chorionic gonadotropin assay (beta-hCG) and by imaging studies which included ultrasound and computerized tomography.

RESULTS

Of 16 cases, 4 achieved complete remission; biochemical remission was obtained in 2 patients who were alive with residual tumor; 10 patients died of the disease. The overall survival rate was 37.5% (6/16).

CONCLUSIONS

The outcome for women presenting with liver metastases from GTT is poor. Early diagnosis and prompt initiation with vigorous multi-agent chemotherapy given through multi-routes are emphasized for improving the treatment outcome.