{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T16:54:37Z","timestamp":1758128077000,"version":"3.41.2"},"reference-count":15,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To audit outcomes of patients registered in the Queensland Trophoblast Centre (QTC) database who develop resistance to primary chemotherapy. To determine any risk factors that may predict first\u2010line chemotherapy resistance in patients diagnosed with gestational trophoblastic neoplasia (GTN).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients within the QTC who were diagnosed with GTN between January 2012 and December 2020 were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 138 patients with GTN registered in the QTC, 22 (15.9%) patients developed resistance to first\u2010line chemotherapy. Three had high\u2010risk GTN and 19 had low\u2010risk GTN. Of the three high\u2010risk patients, one patient died. This patient had an epithelioid trophoblastic tumour (ETT). The remaining two high\u2010risk patients had complete hydatidiform moles (CHM) with GTN. Both achieved complete remission with salvage therapy. Of the 19 low\u2010risk patients, one patient had a partial hydatidiform mole (PHM). This patient achieved remission following third\u2010line treatment. The other 18 low\u2010risk patients had CHM with GTN. All but two of these 18 patients were successfully treated with second\u2010line chemotherapy, with the remaining two patients achieving remission with third\u2010line chemotherapy. Five of the 18 patients received either actinomycin\u2010D or methotrexate as salvage therapy. Thirteen patients were given multi\u2010agent chemotherapy for second\u2010line treatment. One patient in this group died but this was not due to her disease. Initial \u03b2 human chorionic gonadotropin levels were not predictive of number of chemotherapy cycles or number of lines of chemotherapy required to achieve remission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>GTN is a curable condition. If resistance to first\u2010line chemotherapy occurred, most patients achieved remission with salvage therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13912","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T05:28:42Z","timestamp":1734586122000},"page":"398-403","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Outcomes of patients registered with the Queensland Trophoblast Centre diagnosed with gestational trophoblastic neoplasia who develop resistance to chemotherapy"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9238-1354","authenticated-orcid":false,"given":"Meg","family":"Welsh","sequence":"first","affiliation":[{"name":"Metro North Hospital and Health Service The University of Queensland Faculty of Medicine  Brisbane Queensland Australia"},{"name":"Obstetrics and Gynaecology Department Redcliffe Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shona","family":"Morrison","sequence":"additional","affiliation":[{"name":"Queensland Trophoblast Centre Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Baartz","sequence":"additional","affiliation":[{"name":"Queensland Trophoblast Centre Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Sanday","sequence":"additional","affiliation":[{"name":"Queensland Trophoblast Centre Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Garrett","sequence":"additional","affiliation":[{"name":"Queensland Trophoblast Centre Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"},{"name":"Department of Gynaecologic Oncology Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004240"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12622"},{"issue":"6","key":"e_1_2_8_4_1","first-page":"139","article-title":"Gestational trophoblastic disease: ESMO clinical practice guidelines for diagnosis, treatment and follow up","volume":"24","author":"Seckl MJ","year":"2013","journal-title":"Ann Oncol"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000674"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13877"},{"issue":"1","key":"e_1_2_8_7_1","article-title":"Chemotherapy for resistant or recurrent gestational trophoblastic neoplasia","volume":"2016","author":"Alazzam M","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2021.100110"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/IGC.0000000000000534"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.30.4386"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2019.0053"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijmr.IJMR_2585_19"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(21)00262-X"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2004.11.011"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.12613"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2019.03.008"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13912","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T11:26:42Z","timestamp":1753183602000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.13912"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,19]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1111\/ajo.13912"],"URL":"https:\/\/doi.org\/10.1111\/ajo.13912","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"type":"print","value":"0004-8666"},{"type":"electronic","value":"1479-828X"}],"subject":[],"published":{"date-parts":[[2024,12,19]]},"assertion":[{"value":"2024-04-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}