妊娠滋养细胞肿瘤肝转移的诊断和处理

评估对滋养细胞肿瘤肝转移患者的治疗方法及临床预后。方法回顾性分析１９８５－１９９８年收治的滋养细胞肿瘤肝转移患者１６例。所有患者均接受以５－氟尿嘧啶为主的联合化疗或ＥＭＡ／ＣＯ（氨甲蝶呤、更生霉素、足叶乙甙／长春新碱,环磷酰胺）化疗,其中８例进行选择性肝动脉持管局部灌注化疗。通过监测血β－人绒毛膜促性腺激素（β－ＨＣＧ）水平,超声及ＣＴ等检查判断治疗效果。结果１６例患者经以上治疗４例完全缓解,２例

Diagnosis and management of gestational trophoblastic tumor with liver metastases

OBJECTIVE: To evaluate management options and clinical prognosis for women presenting gestational trophoblastic tumor (GTT) with liver metastases. METHODS: We retrospectively analyzed sixteen GTT patients with liver metastases treated in the Peking Union Medical College (PUMC) hospital from 1985 to 1998. All were treated with 5-FU combined chemotherapy or EMA/CO regimen. Eight of them received hepatic artery infusion chemotherapy. Treatment outcome was measured by beta subunit human chorionic gonadotropin assay (beta-hCG) and by imaging studies which included ultrasound and computerized tomography. RESULTS: Of 16 cases, 4 achieved complete remission; biochemical remission was obtained in 2 patients who were alive with residual tumor; 10 patients died of the disease. The overall survival rate was 37.5% (6/16). CONCLUSIONS: The outcome for women presenting with liver metastases from GTT is poor. Early diagnosis and prompt initiation with vigorous multi-agent chemotherapy given through multi-routes are emphasized for improving the treatment outcome.