Izildinha Maestá1, Ross S Berkowitz2, Donald P Goldstein2, Marilyn R Bernstein2, Luz Angela C Ramírez3, Neil S Horowitz2. 1. Department of Gynecology and Obstetrics, Botucatu Medical School, UNESP-Sao Paulo State University, Botucatu, SP, Brazil; Trophoblastic Diseases Center of the Botucatu Medical School, UNESP-Sao Paulo State University, Botucatu, SP, Brazil. Electronic address: imaesta@fmb.unesp.br. 2. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Brigham and Women's Hospital, Boston, USA; New England Trophoblastic Disease Center, Donald P. Goldstein M.D. Tumor Registry, Boston, USA; Dana Farber Cancer Institute/Harvard Cancer Center, Boston, USA; Harvard Medical School, Boston, USA. 3. Department of Gynecology and Obstetrics, Botucatu Medical School, UNESP-Sao Paulo State University, Botucatu, SP, Brazil; Clinical Department, Caldas University, Manizales, Caldas, Colombia.
Abstract
OBJECTIVE: To evaluate the potential effects of race on clinical characteristics, extent of disease, and response to chemotherapy in women with postmolar low-risk gestational trophoblastic neoplasia (GTN). METHODS: This non-concurrent cohort study was undertaken including patients with FIGO-defined postmolar low-risk GTN treated with comparable doses and schedules of chemotherapy at the New England Trophoblastic Disease Center (NETDC) between 1973 and 2012. Racial groups investigated included whites, African American and Asians. Information on patient characteristics and response to chemotherapy (need for second line chemotherapy, reason for changing to an alternative chemotherapy, number of cycles/regimens, need for combination chemotherapy, and time to hCG remission) was obtained. RESULTS: Of 316 women, 274 (86.7%) were white, 19 (6%) African American, and 23 (7.3%) Asian. African Americans were significantly younger than white and Asian women (p=0.008). Disease presentation, and extent of disease, including antecedent molar histology, median time to persistence, median hCG level at persistence, rate of D&C at persistence, presence of metastatic disease, and FIGO stage and risk score were similar among races. Need for second line chemotherapy (p=0.023), and median number of regimens (p=0.035) were greater in Asian women than in other races. CONCLUSIONS: Low-risk GTN was more aggressive in Asian women, who were significantly more likely to need second line chemotherapy and a higher number of chemotherapy regimens to achieve complete remission than women of African American and Asian descent. Further studies involving racial differences related to clinical, biological and environmental characteristics are needed.
OBJECTIVE: To evaluate the potential effects of race on clinical characteristics, extent of disease, and response to chemotherapy in women with postmolar low-risk gestational trophoblastic neoplasia (GTN). METHODS: This non-concurrent cohort study was undertaken including patients with FIGO-defined postmolar low-risk GTN treated with comparable doses and schedules of chemotherapy at the New England Trophoblastic Disease Center (NETDC) between 1973 and 2012. Racial groups investigated included whites, African American and Asians. Information on patient characteristics and response to chemotherapy (need for second line chemotherapy, reason for changing to an alternative chemotherapy, number of cycles/regimens, need for combination chemotherapy, and time to hCG remission) was obtained. RESULTS: Of 316 women, 274 (86.7%) were white, 19 (6%) African American, and 23 (7.3%) Asian. African Americans were significantly younger than white and Asian women (p=0.008). Disease presentation, and extent of disease, including antecedent molar histology, median time to persistence, median hCG level at persistence, rate of D&C at persistence, presence of metastatic disease, and FIGO stage and risk score were similar among races. Need for second line chemotherapy (p=0.023), and median number of regimens (p=0.035) were greater in Asian women than in other races. CONCLUSIONS: Low-risk GTN was more aggressive in Asian women, who were significantly more likely to need second line chemotherapy and a higher number of chemotherapy regimens to achieve complete remission than women of African American and Asian descent. Further studies involving racial differences related to clinical, biological and environmental characteristics are needed.
Authors: Allison A Gockley; Lawrence H Lin; Michelle Davis; Alexander Melamed; Anthony Rizzo; Sue Yazaki Sun; Kevin Elias; Donald P Goldstein; Ross S Berkowitz; Neil S Horowitz Journal: Clinics (Sao Paulo) Date: 2021-08-27 Impact factor: 2.365
Authors: C Tempfer; L-C Horn; S Ackermann; M W Beckmann; R Dittrich; J Einenkel; A Günthert; H Haase; J Kratzsch; M C Kreissl; S Polterauer; A D Ebert; K T M Schneider; H G Strauss; F Thiel Journal: Geburtshilfe Frauenheilkd Date: 2016-02 Impact factor: 2.915
Authors: Jennifer R King; Melissa L Wilson; Szabolcs Hetey; Peter Kiraly; Koji Matsuo; Antonio V Castaneda; Eszter Toth; Tibor Krenacs; Petronella Hupuczi; Paulette Mhawech-Fauceglia; Andrea Balogh; Andras Szilagyi; Janos Matko; Zoltan Papp; Lynda D Roman; Victoria K Cortessis; Nandor Gabor Than Journal: Int J Mol Sci Date: 2019-10-10 Impact factor: 5.923