Table 4 Management and outcome of relapsed disease

From: A comparison of patients with relapsed and chemo-refractory gestational trophoblastic neoplasia

Low risk at initial presentation patients n=35

 Hysterectomy only

2

 Hysterectomy and chemotherapy

EMA/CO 3

EP 1

 Chemotherapy only

EMA/CO 25

CO/EP 1

EP 1

EP/EMA 2

 5-year survival

100%

High risk at initial presentation patients n=25

 Thoracotomy and chemotherapy

EP/EMA 2

POMB ACE 1

EMA/CO 1

 Hysterectomy and chemotherapy

EP/EMA 3

EMA/CO 1

Cis/taxol 1

 Chemotherapy only

EMA/CNS 1

EMA/CO 3

EP/EMA 10

Cisplatin vincristine 1

Cis/taxol 1

 5-year survival

84% (95% CI: 68–99%)

  1. EMA/CO – weekly combination chemotherapy, comprising of etoposide(dose), methotrexate, actinomycin alternating with cyclophosphamide and vincristine (Bower et al, 1997).
  2. POMBACE – cisplatin, vincristine, methotrexate, bleomycin alternating with actinomycin D, cyclophosphamide and etoposide (Newlands et al, 1983).
  3. EP/EMA – etoposide, cisplatin/etoposide, methotrexate and actinomycin D (Newlands et al, 2000).
  4. EMA/CNS – etoposide, methotrexate and actinomycin alternating weekly with vincristine and cyclophosphamide. The dose of methotrexate was increased to 1 g m−2.
  5. Cis/taxol – cisplatin etoposide and paclitaxel (Osborne et al, 2004) EP cisplatin etoposide (IV day 1–5).
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