Objective: To analyze retrospectively the prognosis of gestational trophoblastic neoplasia (GTN) patients who achieved normal beta-hCG titer after completing treatment but remained with residual lung tumor.
Method: A total of 1,130 GTN patients were hospitalized at Peking Union Medical College Hospital from January 1985 to January 2004. Among these patients, 901 achieved complete remission (CR); 152 achieved normal blood beta-hCG titer after the completion of treatment but remained with residual lung tumor (defined as partial remission). Retrospective analyses were carried out on the 152 patients. Statistical analysis was used to compare the recurrent rate of the CR patients with the progression rate of the 152 patients.
Result: 17 of the 152 patients lost follow-up. Of the rest 135 patients followed up from 14 to 110 months, 83 showed no significant changes as to their residual tumors; 46 patients' residual tumors diminished or disappeared; and the other 6 patients got progression of disease (PD), with beta-hCG level going up 6-8 months after completing treatment. There is no significant statistical difference (P > 0.05) between the recurrent rate of the 901 CR patients and the progression rate of the 152 patients. There is also no significant statistical difference (P > 0.05) between the recurrent rate of the CR patients with lung metastasis and the progression rate of the 152 patients.
Conclusion: After achieving normal beta-hCG titer, patients whose lung tumor stayed unchanged even following several additional courses of chemotherapy should be considered as CR patients. Follow-ups should be strictly carried out on these patients, especially at around 6 months after the completion of treatment, and particularly for high-risk and drug-resistant choriocarcinoma (CC) patients.