{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T20:58:46Z","timestamp":1765832326078,"version":"3.48.0"},"reference-count":26,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"11","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Gestational trophoblastic neoplasia (GTN) is a highly curable malignancy classified using the International Federation of Gynecology and Obstetrics (FIGO)\/WHO scoring system into low-risk (score 0-6) and high-risk (score \u2265 7) categories. Although single-agent chemotherapy is standard for low-risk GTN, patients with FIGO scores of 5-6 exhibit disproportionately high rates of chemoresistance, raising concerns about current classification and treatment strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      This retrospective analytic study included 162 patients with low-risk GTN treated at a tertiary referral center in Saudi Arabia from 1980 to 2021. Patients were stratified into FIGO score subgroups (0-4\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      5-6), and data on demographics, treatment regimens, outcomes, and chemoresistance were collected. The primary outcome was resistance to first-line chemotherapy. Multivariable logistic regression identified independent predictors of chemoresistance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      The median patient age was 35 years, with 64.8% age 40 years and younger. Hydatidiform mole was the most common antecedent pregnancy (88.9%), and 30.9% had FIGO scores of 5-6. First-line treatment included single-agent chemotherapy (74.7%) and multiagent regimens (25.3%). Although all patients achieved complete remission, 26.5% exhibited chemoresistance to first-line treatment, significantly associated with treatment before the year 2000, higher FIGO scores, and single-agent chemotherapy. On multivariable analysis, FIGO scores of 5-6 (odds ratio [OR], 2.6;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .02) and single-agent chemotherapy (OR, 0.11;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .007) were independent predictors of resistance. \u03b2-human chorionic gonadotropin (hCG) level was the only FIGO component independently linked to chemoresistance. Relapse occurred in 5.4% of cases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Patients with FIGO scores of 5-6 and high \u03b2-hCG levels had increased resistance to first-line therapy. \u03b2-hCG was the strongest independent predictor. These findings highlight the need to reassess treatment strategies for this subgroup.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/go-25-00172","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T20:57:17Z","timestamp":1765832237000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Treatment Outcome and Chemoresistance-Related Factors of Low-Risk Gestational Trophoblastic Neoplasia: Results From a Tertiary Care Center in Saudi Arabia"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9993-9664","authenticated-orcid":true,"given":"Mohamed","family":"Aseafan","sequence":"first","affiliation":[{"name":"Section of Medical Oncology, Department of Internal Medicine, Security Forces Hospital, Riyadh, Saudi Arabia"},{"name":"Department of Medical Oncology, Cancer Centre of Excellence, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi 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