Surgery and Platinum/Etoposide-Based Chemotherapy for the Treatment of Epithelioid Trophoblastic Tumor

Janelle Sobecki-Rausch, Abigail Winder, Kruti P Maniar, Anna V. Hoekstra, Emily Berry, Karen Novak, John Robert Lurain III*

*Corresponding author for this work

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective Epithelioid trophoblastic tumor (ETT) is a rare variant of gestational trophoblastic neoplasia that develops from chorionic-type intermediate trophoblast, simulates carcinoma, presents years after a pregnancy event, is associated with low or normal human chorionic gonadotropin levels, and is relatively resistant to chemotherapy. Our aim was to identify the role of surgery in combination with platinum/etoposide-based chemotherapy in the management of both localized and metastatic ETT. Methods A retrospective review was performed of women with ETT treated at a gestational trophoblastic disease center from 2010 to 2016. Results Five patients were identified who had complete records. Mean age was 38.0 years. Three women presented with abnormal uterine bleeding, 2 women presented with respiratory complaints, and 1 woman was asymptomatic. Two women had no identifiable antecedent pregnancy, 2 women had spontaneous abortions, and 1 woman had a normal term delivery before diagnosis. Four (80%) of 5 women had metastatic pulmonary disease. All 5 women underwent hysterectomy, and 3 women had resection of metastatic pulmonary disease. The 4 women with metastatic disease were also treated with chemotherapy. All 5 women are currently without evidence of disease. Conclusions Surgery, including hysterectomy and resection of metastatic disease, is an important component in the treatment of women with ETT. Adjuvant chemotherapy with a platinum/etoposide-containing regimen should be used in women with metastatic disease. All 5 women with ETT in this series were cured using this approach, including the 4 who had metastatic disease.

Original languageEnglish (US)
Pages (from-to)1117-1122
Number of pages6
JournalInternational Journal of Gynecological Cancer
Volume28
Issue number6
DOIs
StatePublished - Jul 1 2018

Fingerprint

Trophoblastic Neoplasms
Etoposide
Platinum
Drug Therapy
Therapeutics
Gestational Trophoblastic Disease
Hysterectomy
Lung Diseases
Pregnancy
Uterine Hemorrhage
Trophoblasts

Keywords

  • Epithelioid trophoblastic tumor
  • chemotherapy
  • gestational trophoblastic neoplasia
  • surgery

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this

Sobecki-Rausch, Janelle ; Winder, Abigail ; Maniar, Kruti P ; Hoekstra, Anna V. ; Berry, Emily ; Novak, Karen ; Lurain III, John Robert. / Surgery and Platinum/Etoposide-Based Chemotherapy for the Treatment of Epithelioid Trophoblastic Tumor. In: International Journal of Gynecological Cancer. 2018 ; Vol. 28, No. 6. pp. 1117-1122.
@article{b746765bee2648e5ae13f97c2fe2af93,
title = "Surgery and Platinum/Etoposide-Based Chemotherapy for the Treatment of Epithelioid Trophoblastic Tumor",
abstract = "Objective Epithelioid trophoblastic tumor (ETT) is a rare variant of gestational trophoblastic neoplasia that develops from chorionic-type intermediate trophoblast, simulates carcinoma, presents years after a pregnancy event, is associated with low or normal human chorionic gonadotropin levels, and is relatively resistant to chemotherapy. Our aim was to identify the role of surgery in combination with platinum/etoposide-based chemotherapy in the management of both localized and metastatic ETT. Methods A retrospective review was performed of women with ETT treated at a gestational trophoblastic disease center from 2010 to 2016. Results Five patients were identified who had complete records. Mean age was 38.0 years. Three women presented with abnormal uterine bleeding, 2 women presented with respiratory complaints, and 1 woman was asymptomatic. Two women had no identifiable antecedent pregnancy, 2 women had spontaneous abortions, and 1 woman had a normal term delivery before diagnosis. Four (80{\%}) of 5 women had metastatic pulmonary disease. All 5 women underwent hysterectomy, and 3 women had resection of metastatic pulmonary disease. The 4 women with metastatic disease were also treated with chemotherapy. All 5 women are currently without evidence of disease. Conclusions Surgery, including hysterectomy and resection of metastatic disease, is an important component in the treatment of women with ETT. Adjuvant chemotherapy with a platinum/etoposide-containing regimen should be used in women with metastatic disease. All 5 women with ETT in this series were cured using this approach, including the 4 who had metastatic disease.",
keywords = "Epithelioid trophoblastic tumor, chemotherapy, gestational trophoblastic neoplasia, surgery",
author = "Janelle Sobecki-Rausch and Abigail Winder and Maniar, {Kruti P} and Hoekstra, {Anna V.} and Emily Berry and Karen Novak and {Lurain III}, {John Robert}",
year = "2018",
month = "7",
day = "1",
doi = "10.1097/IGC.0000000000001278",
language = "English (US)",
volume = "28",
pages = "1117--1122",
journal = "International Journal of Gynecological Cancer",
issn = "1048-891X",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

Surgery and Platinum/Etoposide-Based Chemotherapy for the Treatment of Epithelioid Trophoblastic Tumor. / Sobecki-Rausch, Janelle; Winder, Abigail; Maniar, Kruti P; Hoekstra, Anna V.; Berry, Emily; Novak, Karen; Lurain III, John Robert.

In: International Journal of Gynecological Cancer, Vol. 28, No. 6, 01.07.2018, p. 1117-1122.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Surgery and Platinum/Etoposide-Based Chemotherapy for the Treatment of Epithelioid Trophoblastic Tumor

AU - Sobecki-Rausch, Janelle

AU - Winder, Abigail

AU - Maniar, Kruti P

AU - Hoekstra, Anna V.

AU - Berry, Emily

AU - Novak, Karen

AU - Lurain III, John Robert

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Objective Epithelioid trophoblastic tumor (ETT) is a rare variant of gestational trophoblastic neoplasia that develops from chorionic-type intermediate trophoblast, simulates carcinoma, presents years after a pregnancy event, is associated with low or normal human chorionic gonadotropin levels, and is relatively resistant to chemotherapy. Our aim was to identify the role of surgery in combination with platinum/etoposide-based chemotherapy in the management of both localized and metastatic ETT. Methods A retrospective review was performed of women with ETT treated at a gestational trophoblastic disease center from 2010 to 2016. Results Five patients were identified who had complete records. Mean age was 38.0 years. Three women presented with abnormal uterine bleeding, 2 women presented with respiratory complaints, and 1 woman was asymptomatic. Two women had no identifiable antecedent pregnancy, 2 women had spontaneous abortions, and 1 woman had a normal term delivery before diagnosis. Four (80%) of 5 women had metastatic pulmonary disease. All 5 women underwent hysterectomy, and 3 women had resection of metastatic pulmonary disease. The 4 women with metastatic disease were also treated with chemotherapy. All 5 women are currently without evidence of disease. Conclusions Surgery, including hysterectomy and resection of metastatic disease, is an important component in the treatment of women with ETT. Adjuvant chemotherapy with a platinum/etoposide-containing regimen should be used in women with metastatic disease. All 5 women with ETT in this series were cured using this approach, including the 4 who had metastatic disease.

AB - Objective Epithelioid trophoblastic tumor (ETT) is a rare variant of gestational trophoblastic neoplasia that develops from chorionic-type intermediate trophoblast, simulates carcinoma, presents years after a pregnancy event, is associated with low or normal human chorionic gonadotropin levels, and is relatively resistant to chemotherapy. Our aim was to identify the role of surgery in combination with platinum/etoposide-based chemotherapy in the management of both localized and metastatic ETT. Methods A retrospective review was performed of women with ETT treated at a gestational trophoblastic disease center from 2010 to 2016. Results Five patients were identified who had complete records. Mean age was 38.0 years. Three women presented with abnormal uterine bleeding, 2 women presented with respiratory complaints, and 1 woman was asymptomatic. Two women had no identifiable antecedent pregnancy, 2 women had spontaneous abortions, and 1 woman had a normal term delivery before diagnosis. Four (80%) of 5 women had metastatic pulmonary disease. All 5 women underwent hysterectomy, and 3 women had resection of metastatic pulmonary disease. The 4 women with metastatic disease were also treated with chemotherapy. All 5 women are currently without evidence of disease. Conclusions Surgery, including hysterectomy and resection of metastatic disease, is an important component in the treatment of women with ETT. Adjuvant chemotherapy with a platinum/etoposide-containing regimen should be used in women with metastatic disease. All 5 women with ETT in this series were cured using this approach, including the 4 who had metastatic disease.

KW - Epithelioid trophoblastic tumor

KW - chemotherapy

KW - gestational trophoblastic neoplasia

KW - surgery

UR - http://www.scopus.com/inward/record.url?scp=85049589555&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85049589555&partnerID=8YFLogxK

U2 - 10.1097/IGC.0000000000001278

DO - 10.1097/IGC.0000000000001278

M3 - Article

VL - 28

SP - 1117

EP - 1122

JO - International Journal of Gynecological Cancer

JF - International Journal of Gynecological Cancer

SN - 1048-891X

IS - 6

ER -