IMR Press / EJGO / Volume 24 / Issue 2 / pii/2003128

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Original Research

Identification of chemotherapeutic refractory cases based on human chorionic gonadotropin values among patients with low-risk persistent trophoblastic disease treated with 8-day methotrexate-folinic acid

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1 Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Japan
2 Department of Medical Information Science, Kyushu University Hospital, Fukuoka, Japan
Eur. J. Gynaecol. Oncol. 2003, 24(2), 113–116;
Published: 10 April 2003
Abstract

Purpose: The aim of the present study was to establish the accurate cutoff points of post-treatment serum B-hCG values in iden­tifying chemotherapeutic refractory cases among patients with low-risk persistent trophoblastic disease (PTD) treated with 8-day methotrexate-folinic acid as the primary therapy. Materials and methods: The values of serum B-hCG measured before initiating treatment and weekly thereafter in 26 patients with low-risk PTD undergoing 8-day methotrexate-folinic acid treatment were analyzed. Thereafter, we determined the weekly cutoff points to identify the patient refractory for treatment by means of receiver-operating characteristic (ROC) plots analysis. Results: The values of cutoff points in the pretreatment, the post-treatment 1st, 2nd, 3rd, and 4th week were 18.6, 15.0, 5.4, 3.4, and 2.0ng/ml, respectively, and the value of accuracy during these weeks was appropriate (> 80%). When using the cutoff points of one and two weeks after initiating treatment, the accuracy in identifying chemotherapeutic refractory patients was 87.5% and 88.0%, respectively, with the highest values exceeding 85%. The sensitivity and specificity at one week were 92.9 and 80.0%, respectively Similarly, the sensitivity and specificity at two weeks were 93.3 and 80.0%, respectively. Conclusion: These results suggest that the cutoff points of one and two weeks after initiating treatment are useful in identifying chemotherapeutic refractory patients among low-risk PTD patients, receiving 8-day methotrexate-folinic acid treatment.

Keywords
Persistent trophoblastic disease
Low-risk PTD
Methotrexate
Human chorionic gonadotropin
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