{
    "abstract": "Liver metastases of gestational trophoblastic neoplasia (GTN) are rare, but associated with poor prognosis. The additional concomitant presence of brain or intra-abdominal metastases, with liver metastases has been described as worsening factors, but the literature on this topic is reduced.\nTo estimate the overall mortality, specific hepatic morbidity, and mortality, and to identify prognostic factors for patients with GTN and liver metastases.\nThe medical records of 26 GTN patients with liver metastases registered in the French Center for Trophoblastic Diseases and treated between November 1999 and December 2019 were reviewed. Overall survival was described using Kaplan-Meier estimates. Prognostic factors were identified using univariate and multivariate Cox analyses.\nThe 5-year overall survival rate was 60.7% for all patients with liver metastasis. The survival rate was higher in patients who achieved complete remission after first-line chemotherapy than in those who did not (100% vs 20%, p\u00a0=\u00a00.001). The only factor independently associated with prognosis was the presence of 6 or more liver metastases (5-year survival, 16.7% vs. 82.4% otherwise; HR =11.1, 95%CI, 2.3-53.1; p\u00a0=\u00a00.003). None of the five patients with a single liver metastasis died.\nGTN with liver metastasis is very rare (1.6%). The prognosis of patients seems to be improving. The results of this study are also reassuring for patients with complete remission after first-line combination chemotherapy, as well as for those with a single liver metastasis.",
    "authors": [
        {
            "affiliation": "University of Lyon 1, Hospices Civils de Lyon, University Hospital Lyon Sud, Department of Gynecological Surgery and Oncology, Obstetrics, 165 chemin du grand Revoyet, 69495 Pierre B\u00e9nite, France. Electronic address: delphine.raffin@chu-lyon.fr.",
            "firstname": "Delphine",
            "initials": "D",
            "lastname": "Raffin"
        },
        {
            "affiliation": "University of Lyon 1, Hospices Civils de Lyon, University Hospital Lyon Sud, Department of Gynecological Surgery and Oncology, Obstetrics, 165 chemin du grand Revoyet, 69495 Pierre B\u00e9nite, France; French Center for Trophoblastic Diseases, University Hospital Lyon Sud, 165 chemin du grand Revoyet, 69495 Pierre B\u00e9nite, France.",
            "firstname": "Pierre",
            "initials": "P",
            "lastname": "Descargues"
        },
        {
            "affiliation": "French Center for Trophoblastic Diseases, University Hospital Lyon Sud, 165 chemin du grand Revoyet, 69495 Pierre B\u00e9nite, France.",
            "firstname": "Touria",
            "initials": "T",
            "lastname": "Hajri"
        },
        {
            "affiliation": "University of Lyon 1, University Hospital Femme Mere Enfant, Department of Obstetrics and Gynecology, 51, boulevard Pinel, 69500 Bron, France.",
            "firstname": "J\u00e9r\u00f4me",
            "initials": "J",
            "lastname": "Massardier"
        },
        {
            "affiliation": "University of Lyon 1, Hospices Civils de Lyon, University Hospital Lyon Sud, Medical Oncology Department, Investigational Center for Treatments in Oncology and Hematology of Lyon (CITOHL), CICLY EA3738, 165 chemin du grand Revoyet, 69495 Pierre B\u00e9nite, France; Universit\u00e9 Lyon-1, EA 3738 CICLY, Oullins cedex F-69921, France.",
            "firstname": "Benoit",
            "initials": "B",
            "lastname": "You"
        },
        {
            "affiliation": "Sorbonne University, AP-HP, Tenon Hospital, Department of medical oncology, 4 rue de la Chine, 75020 Paris, France.",
            "firstname": "Jean-Pierre",
            "initials": "JP",
            "lastname": "Lotz"
        },
        {
            "affiliation": "Universit\u00e9 Lyon-1, EA 3738 CICLY, Oullins cedex F-69921, France; University of Lyon 1, Hospices Civils de Lyon, University Hospital Lyon Sud, Department of Radiology, 165 chemin du grand Revoyet, 69495 Pierre B\u00e9nite, France.",
            "firstname": "Pascal",
            "initials": "P",
            "lastname": "Rousset"
        },
        {
            "affiliation": "University of Lyon 1, Hospices Civils de Lyon, University Hospital Lyon Sud, Nuclear Medicine Department, 165 chemin du grand Revoyet, 69495 Pierre B\u00e9nite, France.",
            "firstname": "J\u00e9r\u00e9mie",
            "initials": "J",
            "lastname": "Tordo"
        },
        {
            "affiliation": "University of Lyon 1, Hospices Civils de Lyon, University Hospital Lyon Sud, Department of Pathology, 165 chemin du grand Revoyet, 69495 Pierre B\u00e9nite, France.",
            "firstname": "Mojgan",
            "initials": "M",
            "lastname": "Devouassoux-Shisheboran"
        },
        {
            "affiliation": "University of Lyon 1, Hospices Civils de Lyon, University Hospital Lyon Sud, Department of Gynecological Surgery and Oncology, Obstetrics, 165 chemin du grand Revoyet, 69495 Pierre B\u00e9nite, France; French Center for Trophoblastic Diseases, University Hospital Lyon Sud, 165 chemin du grand Revoyet, 69495 Pierre B\u00e9nite, France; Universit\u00e9 Lyon-1, EA 3738 CICLY, Oullins cedex F-69921, France.",
            "firstname": "Fran\u00e7ois",
            "initials": "F",
            "lastname": "Golfier"
        },
        {
            "affiliation": "University of Lyon 1, Hospices Civils de Lyon, University Hospital Lyon Sud, Department of Gynecological Surgery and Oncology, Obstetrics, 165 chemin du grand Revoyet, 69495 Pierre B\u00e9nite, France; French Center for Trophoblastic Diseases, University Hospital Lyon Sud, 165 chemin du grand Revoyet, 69495 Pierre B\u00e9nite, France; Universit\u00e9 Lyon-1, EA 3738 CICLY, Oullins cedex F-69921, France.",
            "firstname": "Pierre-Adrien",
            "initials": "PA",
            "lastname": "Bolze"
        }
    ],
    "conclusions": "GTN with liver metastasis is very rare (1.6%). The prognosis of patients seems to be improving. The results of this study are also reassuring for patients with complete remission after first-line combination chemotherapy, as well as for those with a single liver metastasis.",
    "copyrights": "Copyright \u00a9 2023 Elsevier Masson SAS. All rights reserved.",
    "doi": "10.1016/j.jogoh.2023.102636",
    "journal": "Journal of gynecology obstetrics and human reproduction",
    "keywords": [
        "Chemotherapy",
        "Choriocarcinoma",
        "Gestational trophoblastic neoplasia",
        "Hydatidiform mole",
        "Liver metastasis"
    ],
    "methods": "The medical records of 26 GTN patients with liver metastases registered in the French Center for Trophoblastic Diseases and treated between November 1999 and December 2019 were reviewed. Overall survival was described using Kaplan-Meier estimates. Prognostic factors were identified using univariate and multivariate Cox analyses.",
    "publication_date": "2023-07-28",
    "pubmed_id": "37500013",
    "results": "The 5-year overall survival rate was 60.7% for all patients with liver metastasis. The survival rate was higher in patients who achieved complete remission after first-line chemotherapy than in those who did not (100% vs 20%, p\u00a0=\u00a00.001). The only factor independently associated with prognosis was the presence of 6 or more liver metastases (5-year survival, 16.7% vs. 82.4% otherwise; HR =11.1, 95%CI, 2.3-53.1; p\u00a0=\u00a00.003). None of the five patients with a single liver metastasis died.",
    "title": "Morbidity, mortality, and prognostic factors in gestational trophoblastic neoplasia with liver metastasis.",
    "xml": "<Element 'PubmedArticle' at 0x7885037ae2a0>"
}