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임신성 악성융모종양의 예후인자가 치료결과에 미치는 영향

Other Titles
 (The) influence of prognostic factors on the result of therapy in malignant gestational trophoblastic neoplasm 
Issue Date
1981
Description
의학과/석사
Abstract
[한글] 1972년7월1일부터 1979년12월31일까지 연세대학교 의과대학 부속 세브란스 병원 산부인가에 입원가료를 받았던 89예의 악성융모종양 환자에서 치료전에 사망하였던 6예 및 치료전 자의퇴원한 1예를 제외한 82예의 악성융모종양 환자 중 추적관찰되었던 51예의 총괄적 인 퇴소율(overall remission rate)은 74.5%(38/51)였으며, 비전이성 악성융모종양의 경우는 90.9%(10/11), 전이성 융모종양의 양성예후군은 100%(13/13), 악성예후군은 55.6%(15/27)였다. 융모종양 환자의 예후인자와 치료결과를 비교 관찰하면 1) 40세이상 및 24세 이하의 연령군, 2) 2, 3회의 기와임신 횟수, 3) 만삭 선행임신, 4) 4개월 이상의 증상 및 징후의 기간, 5) 뇌나 간 혹은 다발성 전이, 6) 입원시 처음 측정한 소변의 융모성 성선 자극 홀 몬치가 10만 IU/24시간 이상일 때 불량한 치료 결과를 나타내었다. 현재 화학요법이 악성융모종양의 주된 치료법으로 이용되고 있으나 경우에 따라 적절한 수술요법을 병행하였을 시 전신 화학요법만 단독 시행하였을 때의 70.6% (24/34)보다 좋은 84.6% (11/13)의 퇴소율을 얻었다. 이상의 결과로서, 상기 예후인자를 참고로 하여 치료방법의 결정 및 치료결과를 예측할 수 있을 것으로 사료된다. The influence of prognostic factors on the result of therapy in malignant gestational trophoblastic neoplasm Jin Ho Cho, M.D. Department of Medical Science, The Graduate School, Yonsei University (Directed by professor Hyun Mo Kwak, M.D.) Result of therapy in 51 patients who were followed up among 82 patients with malignant gestational trophoblastic neoplasm(GTN), treated at department of Obstetrics and Gynecology, Yonsei University Medical Center between July 1, 1972 and December 31, 1979 are presented. An overall remission rate of 74.5%(38/51) was achieved: nonmetastatic disease, 90.9%(10/11); good prognosis metastatic GTN, 100%(13/13); poor prognosis metastatic GTN, 55.6%(15/27). Analysis of relationship between prognostic factors and result of therapy in malignant GTN indicated that the following factors were predictive of a poor response to treatment: 1) over 40 years and under 24 years of age, 2) gravida 2, 3, 3) antecedent term pregnancy, 4) duration of symptoms and signs greater than 4 months, 5) metastases to the brain, liver or multiple sites and 6) initial urinary human chorionic gonadotrophin excretion than 100,000 IU/24 hours. Although chemotherapy is the principal modality of therapy in GTN, occasional surgical intervention performed coincident with the systemic chemotherapy achieved better remission rate of 84.6%(11/13) than 70.6%(24/34) in chemotherapy alone. These data provide a basis for a therapeutic classification that allow the prognosis to be defined at the time of diagnosis and facilitates the design of treatment schedules in malignant GTN.
[영문] Result of therapy in 51 patients who were followed up among 82 patients with malignant gestational trophoblastic neoplasm(GTN), treated at department of Obstetrics and Gynecology, Yonsei University Medical Center between July 1, 1972 and December 31, 1979 are presented. An overall remission rate of 74.5%(38/51) was achieved: nonmetastatic disease, 90.9%(10/11); good prognosis metastatic GTN, 100%(13/13); poor prognosis metastatic GTN, 55.6%(15/27). Analysis of relationship between prognostic factors and result of therapy in malignant GTN indicated that the following factors were predictive of a poor response to treatment: 1) over 40 years and under 24 years of age, 2) gravida 2, 3, 3) antecedent term pregnancy, 4) duration of symptoms and signs greater than 4 months, 5) metastases to the brain, liver or multiple sites and 6) initial urinary human chorionic gonadotrophin excretion than 100,000 IU/24 hours. Although chemotherapy is the principal modality of therapy in GTN, occasional surgical intervention performed coincident with the systemic chemotherapy achieved better remission rate of 84.6%(11/13) than 70.6%(24/34) in chemotherapy alone. These data provide a basis for a therapeutic classification that allow the prognosis to be defined at the time of diagnosis and facilitates the design of treatment schedules in malignant GTN.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/117073
Appears in Collections:
2. 학위논문 > 1. College of Medicine (의과대학) > 석사
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