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Recent Advances In Postterm Choriocarcinoma

Posted on:2009-10-03Degree:MasterType:Thesis
Country:ChinaCandidate:J ZhaoFull Text:PDF
GTID:2144360245984466Subject:Obstetrics and gynecology
Abstract/Summary:PDF Full Text Request
Post term choriocarcinoma is a high malignant trophoblastic disease,It has been estimated that choriocarcinoma following a live birth has an incidence of approximately 1 in 50,000 live births,and in our country 16.2% of the choriocarcinma develop after term pregnancies, which usually occurs in reproductive-aged woman .The course of this disease is not very clear, Some reports suggest that intraplacental gestational choriocarcinoma is an origin for those choriocarcinoma that follow a term pregnancy. Most of the patients present with vaginal bleeding, abdominal pain and metastasis symptoms such as cough, hemoptysis, dyspnea, hemiplegic paralysis and so on. Pelvic examination suggests subinvolution or larger, serum HCG is higher than normal. Compared with other types of choriocarcinoma, postterm choriocarcinoma has the tendency to show more extensive metastatic spread and is less responsive to conventional chemotherapy. It should be treated with combination chemotherapy, including EMA/CO, BEP,in the rescent years, it was reported that newer anticancer agents such as paclitaxel has a role in the treatment of postterm choriocarcinoma.several factors associated with poor prognosis, An interval of more than four months since the antecedent pregnancy, a pretreatment HCG level≥40,000mIU/ml, with brain or liver metastases ,WHO score higher than 8 scores continue to be significant predictors of a poor outcome. Previous studies of such choriocarcinoma have reported a mortality rate of 33-40%, But it has a high probability of cure if therapy is prompt and appropriate. In this article ,we discussed about the etiology , pathology, clinical manifestation, diagnostic and treatment, hoping to increase probability of cure with early diagnosis and decrease the misdiagnosis rate.
Keywords/Search Tags:choriocarcinoma, post term, postpartum, metastasis, prognosis, human chorionic gonadotropin
PDF Full Text Request
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