Background:
@EN For adequate clinical classification and management of gestational trophoblastic tumors(GTT), metastatic survey is very important. But expensive cost for high resolution radiologic examination and relatively low incidence of high risk site
metastasis made us to evaluate the efficacy of minimal work-up in detecting metastatic sites.
@ES Materials and Methods:
@EN Between 1980 and 1992, 110 patients with non metastatic and 128 patients with metastatic Gestational Trophoblastic Tumors were enlisted at oncology department of Seoul National University Hospital. These patient's records were reviewed and
factors
which might predict the presence of high risk sites metastases(brain, liver, kidney, spleen, et al) were identified.
@ES Results:
@EN Characteristics of high risk site metastatic patients were metastases in lungs or vagina(22/24,92%), at least one or more other poor prognosis factor(i.e.,β-HCG titer>40,000mIU/ml, greater than 4 months since onset of symptoms, antecedent
term
pregnancy) (18/24, 75%), obvious symptoms or signs related to high risk site metastases(23/24.97%). On the basis of these data, we evaluated the efficacy of minimal staging work-up according to the folowing criteria.
1) all patients received history, physical examination, HCG level, and chest PA radiogaphy 2) only patients with lung or vaginal metastases or obvious symptoms received a brain and abdomen C-T scan. Using this criteria, minimal staging work-up
for
the
patients with high risk site metastases were identified with sensitiveity of 100%, and specificity of 51.40%.
@ES Conclusions:
@EN Minimal staging work-up can save the cost and time by reducing unnecessary CT scanning in approximately 46% of patients with GTT. Further study is necessary to assess the actual role of minimal work-up in the management of GTT.
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