Department of Obstetrics & Gynecology, University of Toronto, Toronto, ON M5G 1E2, Canada; Division of Gynecologic Oncology, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada; Department of Medical Oncology, Charing Cross Gestational Trophoblastic Disease Centre, Hammersmith Hospitals Campus of Imperial College, London W6 8RF, UK.
Department of Medical Oncology, Charing Cross Gestational Trophoblastic Disease Centre, Hammersmith Hospitals Campus of Imperial College, London W6 8RF, UK.
Gynecol Oncol. 2020 Sep;158(3):698-701. doi: 10.1016/j.ygyno.2020.06.483. Epub 2020 Jul 9.
There remains uncertainty about the prognostic significance of residual lung lesion on imaging after completion of treatment of low- or high-risk gestational trophoblastic neoplasia (GTN). Here, we determine if such residual lung lesions are associated with an increased risk of relapse.
We retrospectively screened our electronic database to identify patients with low- or high-risk GTN and lung metastases between 2004 and 18. Recurrences among patients with or without residual lung lesions on imaging were compared. Chi square analysis and Kaplan-Meier survival curves were constructed. As the numbers of cases were low, we combined this data with our previously published and non-overlapping patient cohort (1995-2004).
Of 1304 GTN patients treated at our centre between 2004 and 18, 99 had lung metastases without other distant sites. There were 40 patients (40.4%) with residual lung lesions. Whilst an increased rate of relapse was observed among patients with residual lung lesions (4/40; 10.0%) compared to without such lesions (3/59; 5.1%), this difference was not statistically significant (p = .35). By combining the data with our previous cohort, there was an increase in relapse rate of patients with residual lung lesions (5/63; 7.9%) compared to those without such lesions (4/112; 3.6%). However, this difference was also not statistically significant (p = .21).
Residual lung lesions on imaging after completion of GTN treatment are common. However, this finding did not statistically increase relapse rate. Due to low number of recurrent events, a multi-centre, larger dataset would be needed to provide more definitive evidence.
对于低危或高危妊娠滋养细胞肿瘤（GTN）治疗完成后影像学上残留肺部病变的预后意义仍存在不确定性。在此，我们确定此类残留肺部病变是否与复发风险增加相关。
我们回顾性筛选了我们的电子数据库，以确定 2004 年至 2018 年期间患有低危或高危 GTN 和肺部转移的患者。比较影像学上有或无残留肺部病变的患者的复发情况。进行卡方分析和 Kaplan-Meier 生存曲线构建。由于病例数量较少，我们将此数据与我们之前发表的且无重叠的患者队列（1995-2004 年）相结合。
在我们中心治疗的 1304 例 GTN 患者中，99 例无其他远处部位的肺部转移。40 例（40.4%）患者有残留肺部病变。虽然残留肺部病变的患者（4/40；10.0%）的复发率高于无此类病变的患者（3/59；5.1%），但差异无统计学意义（p=0.35）。通过将数据与我们之前的队列相结合，有残留肺部病变的患者（5/63；7.9%）的复发率高于无此类病变的患者（4/112；3.6%）。然而，这一差异也没有统计学意义（p=0.21）。
GTN 治疗完成后影像学上残留肺部病变很常见。然而，这一发现并未显著增加复发率。由于复发事件数量较少，需要多中心、更大的数据集来提供更明确的证据。
