Fatal gestational trophoblastic disease: An analysis of treatment failures

John Robert Lurain III*, John I. Brewer, Michael T. Mazur, Elizabeth E. Torok

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


Forty-eight of 399 patients referred to the John I. Brewer Trophoblastic D isease Center of Northwestern University Medical School from 1962 to 1979 for treatment of gestational trophoblastic disease (invasive mole or choriocarcinoma) died. All patients who died had histologically documented metastatic choriocarcinoma. The time from pregnancy event to treatment was >4 months and/or the pretreatment human chorionic gonadotropin titer was >100,000 IU/L in 64% of these patients. Seventy-one percent of fatal cases developed in association with term pregnancies, abortions, or ectopic pregnancies rather than hydatidiform moles. Fifty percent of patients who died had metastases to the liver, brain, and/or peritoneal cavity when they first presented for treatment. The most common causes of death were hemorrhage from one or more metastatic sites (42%) and pulmonary insufficiency (31%). Factors primarily responsible for the treatment failures in these patients were: (1) presence of extensive disease at the time of initial treatment; (2) inadequate initial treatment; and (3) failure of presently used chemotherapy protocols in advanced disease. Secondary chemotherapy, radiation therapy to sites other than the brain, and adjuvant surgical procedures failed to improve survival in these high-risk patients.

Original languageEnglish (US)
Pages (from-to)391-395
Number of pages5
JournalAmerican journal of obstetrics and gynecology
Issue number4
StatePublished - Oct 15 1982

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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