SynthesisBJOG : an international journal of obstetrics and gynaecology2023
Treatments and outcomes in high-risk gestational trophoblastic neoplasia: A systematic review and meta-analysis.
Synthesis in BJOG : an international journal of obstetrics and gynaecology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 17 citations in OpenAlex.
- Gestational trophoblastic neoplasia treated with low-dose induction chemotherapy despite prognostic score < 13: a case report.Gynecologic oncology reports · 2026Article
- Repurposing metformin for choriocarcinoma: targeting the AMPK/mTOR pathway.Naunyn-Schmiedeberg's archives of pharmacology · 2026Review
- Gestational Trophoblastic Disease: Diagnostic and Therapeutic Updates in Light of Recent Evidence: A Literature Review.Medicina (Kaunas, Lithuania) · 2025Review
- Article
- Molar Pregnancy: Early Diagnosis, Clinical Management, and the Role of Referral Centers.Diagnostics (Basel, Switzerland) · 2025Review
- Treatment outcomes and the role of surgery in gestational trophoblastic neoplasia: a population-based cohort study.Acta oncologica (Stockholm, Sweden) · 2025Article
- Article
- Fertility Sparing Medical Management Options in Gynecologic Cancers.Current treatment options in oncology · 2025Review
- Diagnostic pitfall in primary cervical gestational choriocarcinoma: a case report.Frontiers in oncology · 2025Article
- Management and prognosis of ultra high-risk gestational trophoblastic neoplasia patients: a long-term retrospective study.Therapeutic advances in medical oncology · 2025Article
- Intracardiac metastasis of gestational choriocarcinoma: a case report and literature review.BMC pregnancy and childbirth · 2024Review
- Placental-site trophoblastic tumor with bone metastasis: A diagnostic and therapeutic challenge.Gynecologic oncology reports · 2023Article
- Treatment Outcome and Associated Factors Among Women With Gestational Trophoblastic Neoplasia in Northwest Ethiopia: A Multi-Center Retrospective Cohort Study.Cancer control : journal of the Moffitt Cancer CenterArticle
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundHigh-risk gestational trophoblastic neoplasia (GTN) is rare and treated with diverse approaches. Limited published institutional data has yet to be systematically reviewed.
objectivesTo compile global high-risk GTN (prognostic score ≥7) cohorts to summarise treatments and outcomes by disease characteristics and primary chemotherapy. SEARCH STRATEGY: MEDLINE, Embase, Scopus, ClinicalTrials.gov and Cochrane were searched through March 2021. SELECTION CRITERIA: Full-text manuscripts reporting mortality among ≥10 high-risk GTN patients. DATA COLLECTION AND ANALYSIS: Binomial proportions were summed, and random-effects meta-analyses performed. MAIN
resultsFrom 1137 records, we included 35 studies, representing 20 countries. Among 2276 unique high-risk GTN patients, 99.7% received chemotherapy, 35.8% surgery and 4.9% radiation. Mortality was 10.9% (243/2236; meta-analysis: 10%, 95% confidence interval [CI] 7-12%) and likelihood of complete response to primary chemotherapy was 79.7% (1506/1890; meta-analysis: 78%, 95% CI: 74-83%). Across 24 reporting studies, modern preferred chemotherapy (EMA/CO or EMA/EP) was associated with lower mortality (overall: 8.8 versus 9.5%; comparative meta-analysis: 8.1 versus 12.4%, OR 0.42, 95% CI: 0.20-0.90%, 14 studies) and higher likelihood of complete response (overall: 76.6 versus 72.8%; comparative meta-analysis: 75.9 versus 60.7%, OR 2.98, 95% CI: 1.06-8.35%, 14 studies), though studies focused on non-preferred regimens reported comparable outcomes. Mortality was increased for ultra-high-risk disease (30 versus 7.5% high-risk; meta-analysis OR 7.44, 95% CI: 4.29-12.9%) and disease following term delivery (20.8 versus 7.3% following molar pregnancy; meta-analysis OR 2.64, 95% CI: 1.10-6.31%). Relapse rate estimates ranged from 3 to 6%.
conclusionsHigh-risk GTN is responsive to several chemotherapy regimens, with EMA/CO or EMA/EP associated with improved outcomes. Mortality is increased in patients with ultra-high-risk, relapsed and post-term pregnancy disease.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.