Management of patients with metastatic gestational trophoblastic tumor.

OBJECTIVE This study was designed to analyze the results of treatment on patients with metastatic gestational trophoblastic tumor (metastatic GTT). METHOD During 1996-2001, 38 cases with metastatic GTT were diagnosed and received treatment in Vali-e-Asr Hospital, Tehran, Iran. Data were gathered retrospectively and analyzed based on therapy and response rate. Sixteen patients initially labeled as low-risk, four as middle-risk and eighteen as high-risk patients according to FIGO scoring system (1992). Thirty-four (89.5%) patients responded to treatment; 13 to single-agent [methotrexate (MTX) or ACT] and 21 to multiagent chemotherapy [EMA/cisplatinum and etoposide (EMA-EP) or MTX, ACT-D and cyclophosphamide or chlorambucil (MAC)]. RESULTS All low-risk patients, 2 middle-risk patients and 16 high-risk patients responded to treatment. Four cases failed to respond to therapy due to CNS involvement. CONCLUSIONS Patients with low-risk metastatic GTT have a 100% chance to response to single-agent chemotherapy and those with high-risk disease have great chance to response to multiagent chemotherapy such as EMA-EP.