[Management and risk factors of recurrent gestational trophoblastic tumor]

To analyze the management, prognosis and prognostic risk factors of recurrent gestational trophoblastic tumor (GTT).

One thousand one hundred and thirty GTT patients, aged 29 +/- 6, were hospitalized and treated and 901 of them got complete remission (CR). Among these CR patients, 31 suffered relapsed. The clinical data of these 31 cases were analyzed retrospectively.

Thirty-one patients suffered 15.3 months (6-72 months) after the cessation of treatment with an overall recurrence rate of 3.4% (31/901). Four of the 31 patients suffered relapse repeatedly (totally seven times), resulting in an overall re-recurrence rate of 22.6% (7/31). Twenty-five of the 31 patients were re-hospitalized and received treatment. Eighteen of them got complete remission (CR), 3 got partial remission (PR), and 4 died of progress of the disease (PD). The major adverse prognostic risk factors included: clinical stage (P < 0.05), an interval of more than 12 months from the antecedent pregnancy to chemotherapy (OR = 3.170, P < 0.05), declination of beta-hCG level back to normal titer after more than seven courses of chemotherapy (OR = 4.775, P < 0.05), and less than two courses of consolidation chemotherapy (OR = 0.441, P < 0.05).

More attention should be given to those GTT patients with adverse prognostic risk factors. Multi-drug and multiple route chemotherapy and/or combined surgical intervention can be used to improve the cure rate and lower the re-recurrence rate of the GTT recurrent patients.