Department of Gynecologic Oncology, Centre for Gynecologic Oncology Amsterdam, Location Antoni van Leeuwenhoek - The Netherlands Cancer Institute, Amsterdam, the Netherlands.
Department of Gynecologic Oncology, Centre for Gynecologic Oncology Amsterdam, Location Antoni van Leeuwenhoek - The Netherlands Cancer Institute, Amsterdam, the Netherlands.
Eur J Cancer. 2020 May;130:228-240. doi: 10.1016/j.ejca.2020.02.011. Epub 2020 Apr 1.
Gestational trophoblastic disease (GTD) is a heterogeneous group of disorders characterised by abnormal proliferation of trophoblastic tissue. Since GTD and its malignant sequel gestational trophoblastic neoplasia (GTN) are rare diseases, little evidence is available from randomised controlled trials on optimal treatment and follow-up. Treatment protocols vary within Europe, and even between different centres within countries. One of the goals of the 'European Organisation for Treatment of Trophoblastic Diseases' (EOTTD) is to harmonise treatment in Europe. To provide a basis for European standardisation of definitions, treatment and follow-up protocols in GTD, we composed a set of guidelines for minimal requirements and optimal management of GTD.
Members from each EOTTD country attended multiple workshops during annual EOTTD meetings. Clinical guidelines were formulated by consensus and evidence where available. The following guidelines were discussed: diagnostics of GTD and GTN, treatment of low-risk GTN, high-risk GTN, ultra-high-risk GTN, placental site and epithelioid trophoblastic tumours and follow-up.
Between 40 and 65 EOTTD members from 17 European countries and 7 non-European countries attended the clinical workshops held on 6 occasions. Flow diagrams for patient management were composed to display minimum and best practice for most treatment situations. New agreed definitions of recurrence and chemotherapy resistance were formulated.
Despite the many differences between and within the participating countries, an important step in uniform treatment of GTD and GTN within Europe was made by the Clinical Working Party of the EOTTD. This is an example on how guidelines and harmonisation can be achieved within international networks.
滋养细胞肿瘤（GTD）是一组以滋养细胞异常增生为特征的异质性疾病。由于 GTD 及其恶性续发病——妊娠滋养细胞肿瘤（GTN）是罕见疾病，因此随机对照试验提供的最佳治疗和随访证据有限。欧洲的治疗方案各不相同，甚至在同一国家的不同中心之间也存在差异。欧洲滋养细胞疾病治疗组织（EOTTD）的目标之一是协调欧洲的治疗方法。为了为 GTD 的定义、治疗和随访方案的欧洲标准化提供基础，我们制定了一套 GTD 最低要求和最佳管理指南。
来自每个 EOTTD 国家的成员在 EOTTD 年会上多次参加了多个研讨会。根据可用的证据和共识制定了临床指南。讨论了以下指南：GTD 和 GTN 的诊断、低风险 GTN、高风险 GTN、超高风险 GTN、胎盘部位和上皮样滋养细胞肿瘤以及随访的治疗。
来自 17 个欧洲国家和 7 个非欧洲国家的 40 至 65 名 EOTTD 成员参加了 6 次临床研讨会。为了展示大多数治疗情况的最低和最佳实践，我们制作了患者管理流程图。还制定了新的复发和化疗耐药的商定定义。
尽管参与国家之间存在许多差异，但 EOTTD 临床工作组在欧洲统一治疗 GTD 和 GTN 方面迈出了重要一步。这是在国际网络中实现指南和协调的一个例子。
