Wb. Jones et al., THE ROLE OF SURGERY IN THE MANAGEMENT OF GESTATIONAL TROPHOBLASTIC DISEASE, International journal of gynecological cancer, 6(4), 1996, pp. 261-266
Between November 1967 and December 1994, 242 patients with gestational
trophoblastic disease (GTD) were treated with chemotherapy by the Gyn
ecology Service of Memorial Hospital. Eighty-seven of the patients (35
.9%) underwent at least one major operation during the course of their
illness. Twenty-six patients underwent two major operations, and in f
ive patients, three major operations were performed, for a total of 11
8 procedures. The most frequent procedures were: hysterectomy, 56 (47.
4%); hysterotomy, 15 (12.7%); thoracotomy, 13 (11%); and craniotomy, 5
(4.2%). Twenty-nine additional procedures ranging in complexity from
oophorectomy to segmental liver resection were also performed. Twenty-
nine operations (24.5%) were considered to be beyond the scope of most
gynecologic surgeons. The overall complete remission rate for 242 pat
ients was 90.4%. The rate for patients who underwent a major surgical
procedure was 79.3% compared to 96.7% for patients whose treatment was
with chemotherapy alone. The data demonstrate that the integration of
surgery in the management of GTD patients often requires a multidisci
plinary approach that in many cases can best be achieved at specialize
d treatment centers.