Bagshawe K D
J Reprod Med. 1984 Nov;29(11):813-20.
Risk has different meanings even within the confines of trophoblastic disease. One unquantifiable risk for patients is treatment by physicians or surgeons with limited knowledge of this rare disease and its modern management. Risk can be immediate at the time of presentation because the disease has sometimes progressed to a life-threatening state before the diagnosis is established. Special problems at that time need consideration on the basis of which organs are involved. Placental-site trophoblastic disease presents distinctive features and requires different management. A major long-term risk is drug resistance, and a high proportion of late treatment failures in choriocarcinoma arise from inappropriate therapy at an early stage in treatment. "Prognostic," or "risk," scoring identifies the propensity of a tumor to become resistant to chemotherapy and enables treatment to be planned from the outset to minimize that risk.
即使在滋养细胞疾病的范畴内，风险也有不同的含义。对患者来说，一种无法量化的风险是由对这种罕见疾病及其现代治疗方法了解有限的内科医生或外科医生进行治疗。就诊时风险可能是即刻的，因为在确诊之前，疾病有时已进展到危及生命的状态。此时需要根据受累器官考虑特殊问题。胎盘部位滋养细胞疾病有其独特特征，需要不同的治疗方法。一个主要的长期风险是耐药性，绒毛膜癌晚期治疗失败的很大一部分原因是治疗早期的不恰当治疗。“预后”或“风险”评分可确定肿瘤对化疗产生耐药性的倾向，并能从一开始就规划治疗以将该风险降至最低。
