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Lima LDELA, Padron L, Câmara R, Sun SY, Rezende J, Braga A. The role of surgery in the management of women with gestational trophoblastic disease. Rev Col Bras Cir 2018; 44:94-101. [PMID: 28489216 DOI: 10.1590/0100-69912017001009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 12/09/2016] [Indexed: 02/07/2023] Open
Abstract
The Gestational Trophoblastic Disease includes an interrelated group of diseases originating from placental tissue, with distinct behaviors concerning local invasion and metastasis. The high sensitivity of the serial dosages of human chorionic gonadotrophin, combined with advances in chemotherapy treatment, have made gestational trophoblastic neoplasia curable, most often through chemotherapy. However, surgery remains of major importance in the management of patients with gestational trophoblastic disease, improving their prognosis. Surgery is necessary in the control of the disease's complications, such as hemorrhage, and in cases of resistant/relapsed neoplasia. This review discusses the indications and the role of surgical interventions in the management of women with molar pregnancy and gestational trophoblastic neoplasia. RESUMO Doença trofoblástica gestacional inclui um grupo interrelacionado de doenças originadas do tecido placentário, com tendências distintas de invasão local e metástase. A alta sensibilidade das dosagens seriadas de gonadotrofina coriônica humana aliada aos avanços do tratamento quimioterápico tornou a neoplasia trofoblástica gestacional, curável, na maioria das vezes, através da quimioterapia. No entanto, a cirurgia permanece ainda, da maior importância na condução de pacientes com doença trofoblástica gestacional, melhorando seu prognóstico. A cirurgia é necessária no controle de complicações da doença, tais como hemorragia, e em casos de neoplasia resistente/recidivada. Esta revisão discute as indicações e o papel das intervenções cirúrgicas durante o manejo de mulheres com gravidez molar e neoplasia trofoblástica gestacional.
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Affiliation(s)
- Lana DE Lourdes Aguiar Lima
- - Federal University of Rio de Janeiro, Center for Trofoblastic Disease of the Maternity School, Rio de Janeiro, Rio de Janeiro State, Brazil.,- Federal University of Rio de Janeiro, Post-Graduate Program in Perinatal Health of the Maternity School, Rio de Janeiro, Rio de Janeiro State, Brazil
| | - Lílian Padron
- - Federal University of Rio de Janeiro, Center for Trofoblastic Disease of the Maternity School, Rio de Janeiro, Rio de Janeiro State, Brazil.,- Fluminense Federal University, Post-Graduate Program in Medical Sciences, Niterói, Rio de Janeiro State, Brazil
| | - Raphael Câmara
- - Federal University of Rio de Janeiro, Center for Trofoblastic Disease of the Maternity School, Rio de Janeiro, Rio de Janeiro State, Brazil.,- Federal University of Rio de Janeiro, Institute of Gynecology, Rio de Janeiro, Rio de Janeiro State, Brazil
| | - Sue Yazaki Sun
- - Paulista School of Medicine, Federal University of São Paulo, Center for Trophoblastic Diseases of the São Paulo Hospital, Sao Paulo, Sao Paulo State, Brazil
| | - Jorge Rezende
- - Federal University of Rio de Janeiro, Center for Trofoblastic Disease of the Maternity School, Rio de Janeiro, Rio de Janeiro State, Brazil.,- Federal University of Rio de Janeiro, Post-Graduate Program in Perinatal Health of the Maternity School, Rio de Janeiro, Rio de Janeiro State, Brazil
| | - Antônio Braga
- - Federal University of Rio de Janeiro, Center for Trofoblastic Disease of the Maternity School, Rio de Janeiro, Rio de Janeiro State, Brazil.,- Federal University of Rio de Janeiro, Post-Graduate Program in Perinatal Health of the Maternity School, Rio de Janeiro, Rio de Janeiro State, Brazil.,- Fluminense Federal University, Post-Graduate Program in Medical Sciences, Niterói, Rio de Janeiro State, Brazil
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Patni R. Gestational Trophoblastic Neoplasia: The Role of Surgery Cannot be Undermined! INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2017. [DOI: 10.1007/s40944-017-0157-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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