{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:22:52Z","timestamp":1787772172842,"version":"build-2784847793"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Gestational trophoblastic neoplasia (GTN) are a spectrum of tumors that develop from placental tissue. We aimed to evaluate the management and treatment outcome of GTN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Patients diagnosed with GTN presented to Kasr Alainy Center of Clinical Oncology between 2008 and 2017 were included in this study. Patients were assigned to low or high-risk according to the World Health Organization (WHO) scoring system. All data were tabulated and statistically studied by descriptive analysis; comparison between the two groups was done using student\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -test for continuous data and Chi-square test for categorical data.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 111 patients were studied; the majority of them had WHO low-risk score. In low-risk group, the overall response rate to methotrexate-folinic acid (MTX- FA) or actinomycin D (ActD) was 48.5%, comparable response rate observed between MTX and ActD was 48.2% vs 50%, respectively. Those who received MTX-FA 8-day regimen had higher response rate compared to a weekly schedule, however, no statistical significant difference was observed (51.6% vs 44.4%, respectively,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.586), all low-risk patients who failed MTX or ActD achieved complete remission (CR) with subsequent chemotherapy. Patients with WHO score 5\u20136 had a significantly lower CR rate compared to patients with scores &lt;5, (28% and 60%, respectively;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.01). Five-years overall survival was significantly lower in high-risk than low-risk patients (79.3% vs 100%, respectively,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Low-risk patients have a survival rate of 100% even if they did not respond to first-line chemotherapy, MTX-FA 8-day regimen seems to be more effective than MTX weekly regimen.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijc.ijc_551_19","type":"journal-article","created":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T06:28:11Z","timestamp":1712730491000},"page":"46-53","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Treatment outcome of gestational trophoblastic neoplasia patients in Egypt"],"prefix":"10.4103","volume":"59","author":[{"given":"Wael A","family":"Edesa","sequence":"first","affiliation":[{"name":"Clinical Oncology Department, Faculty of Medicine, Cairo University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noha N","family":"Ayad","sequence":"additional","affiliation":[{"name":"Clinical Oncology Department, Faculty of Medicine, Cairo University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraf M","family":"Mounir","sequence":"additional","affiliation":[{"name":"Clinical Oncology Department, Faculty of Medicine, Cairo University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamdouh H","family":"Haggag","sequence":"additional","affiliation":[{"name":"Clinical Oncology Department, Faculty of Medicine, Cairo University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,10,2]]},"reference":[{"key":"R1-20250603","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/S0140-6736(10)60280-2","article-title":"Gestational trophoblastic disease","volume":"376","author":"Seckl","year":"2010","journal-title":"Lancet"},{"key":"R2-20250603","doi-asserted-by":"crossref","first-page":"361","DOI":"10.3181\/00379727-93-22757","article-title":"Effect of methotrexate therapy upon choriocarcinoma and chorioadenoma","volume":"93","author":"Hertz","year":"1956","journal-title":"Proc Soc Exp Biol Med"},{"key":"R3-20250603","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1111\/j.1471-0528.1991.tb10369.x","article-title":"Results with the EMA\/CO (etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine) regimen in high risk gestational trophoblastic tumours, 1979 to 1989","volume":"98","author":"Newlands","year":"1991","journal-title":"Br J Obstet Gynaecol"},{"key":"R4-20250603","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/S0020-7292(03)90120-2","article-title":"FIGO committee on gynecologic oncology. Gestational trophoblastic neoplasia, FIGO 2000 staging and classification","volume":"83","author":"Ngan","year":"2003","journal-title":"Int J Gynaecol Obstet"},{"key":"R5-20250603","doi-asserted-by":"crossref","first-page":"121","DOI":"10.11604\/pamj.2019.33.121.13897","article-title":"Gestational trophoblastic neoplasia: Experience at Salah Azaiez Institute","volume":"33","author":"Batti","year":"2019","journal-title":"Pan Afr Med J"},{"key":"R6-20250603","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1056\/NEJMoa021423","article-title":"Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults","volume":"348","author":"Calle","year":"2003","journal-title":"N Engl J Med"},{"key":"R7-20250603","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1097\/IGC.0000000000000398","article-title":"Response to chemotherapy in overweight\/obese patients with low-risk gestational trophoblastic 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Cancer"},{"key":"R11-20250603","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1006\/gyno.2001.6271","article-title":"Weekly intravenous methotrexate with folinic acid for non-metastatic gestational trophoblastic neoplasia","volume":"82","author":"Kwon","year":"2001","journal-title":"Gynecol Oncol"},{"key":"R12-20250603","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.ygyno.2014.12.024","article-title":"A retrospective study to evaluate single agent methotrexate treatment in low risk gestational choriocarcinoma in the United Kingdom","volume":"136","author":"Taylor","year":"2015","journal-title":"Gynecol Oncol"},{"key":"R13-20250603","doi-asserted-by":"crossref","first-page":"1810","DOI":"10.1038\/bjc.2012.462","article-title":"Treatment outcomes for 618 women with gestational trophoblastic tumors following a molar pregnancy at the Charing Cross Hospital, 2000-2009","volume":"107","author":"Lumsden","year":"2012","journal-title":"Br J 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gestational trophoblastic neoplasia","volume":"26","author":"Goldstein","year":"2012","journal-title":"Hematol Oncol Clin North Am"},{"key":"R18-20250603","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1136\/ijgc-00009577-200603000-00064","article-title":"Evolution of treatment of high-risk metastatic gestational trophoblastic tumors: Ain Shams University experience","volume":"16","author":"El-Lamie","year":"2006","journal-title":"Int J Gynecol Cancer"},{"key":"R19-20250603","first-page":"829","article-title":"Relapsed gestational trophoblastic neoplasia: A 20-year experience","volume":"51","author":"Ngan","year":"2006","journal-title":"J Reprod Med"},{"key":"R20-20250603","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1200\/JCO.2014.57.5332","article-title":"Effects of single-agent and combination chemotherapy for gestational trophoblastic tumors on risks of second malignancy and early menopause","volume":"33","author":"Savage","year":"2015","journal-title":"J Clin Oncol"}],"container-title":["Indian Journal of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijc.IJC_551_19","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:30:32Z","timestamp":1787769032000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijc.IJC_551_19"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,2]]},"references-count":20,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/ijc.ijc_551_19","relation":{},"ISSN":["0019-509X","1998-4774"],"issn-type":[{"value":"0019-509X","type":"print"},{"value":"1998-4774","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,2]]},"assertion":[{"value":"2019-06-17","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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