Didactics-Recurrent GTN

Video Transcription

Video Summary

The video discusses the surveillance and treatment of gestational trophoblastic neoplasia (GTN), a type of cancer that develops from the placenta during pregnancy. It mentions that GTN can be detected through a standard serum assay that measures human chorionic gonadotropin (HCG) levels, with a recommended threshold of three to five MIU/mL. The video notes that monthly HCG surveillance is recommended for about 12 months after admission for GTN treatment, and in the UK, HCG monitoring may continue for up to 10 years. Risk factors for GTN recurrence are discussed, including high-risk disease, high initial HCG values, multiple chemotherapy cycles, and certain patient characteristics. The importance of consolidation therapy after remission is emphasized, with recommendations for the number of cycles depending on initial chemotherapy and response. The video also explains when recurrence typically occurs and how to manage recurrent GTN, including radiologic staging, alternative chemotherapy regimens, surgery, and radiation therapy. The presenter mentions various chemotherapy regimens used for treating GTN, including EMICO, EP-EMA, paclitaxel/cisplatin/atoposide, and salvage therapies. The video concludes with a discussion on the remission rates and potential curative outcomes for GTN patients.

Asset Subtitle

John Soper
November 2020

Keywords

gestational trophoblastic neoplasia

placenta cancer

HCG levels

monthly surveillance

recurrent GTN