TY - JOUR T1 - The role of surgery in the management of gestational trophoblastic disease JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer SP - 261 LP - 266 DO - 10.1136/ijgc-00009577-199607000-00003 VL - 6 IS - 4 AU - W. B. Jones AU - J. Wolchok AU - J. L. Lewis Y1 - 1996/07/01 UR - http://ijgc.bmj.com/content/6/4/261.abstract N2 - Between November 1967 and December 1994, 242 patients with gestational trophoblastic disease (GTD) were treated with chemotherapy by the Gynecology Service of Memorial Hospital. Eighty-seven of the patients (35.9%) underwent at least one major operation during the course of their illness. Twenty-six patients underwent two major operations, and in five patients, three major operations were performed, for a total of 118 procedures. The most frequent procedures were: hysterectomy, 56 (47.4%); hysterotomy, 15 (12.7%); thoracotomy, 13 (11%); and craniotomy, 5(4.2%). Twenty-nine additional procedures ranging in complexity from oophorectomy to segmental liver resection were also performed. Twenty-nine operations (24.5%) were considered to be beyond the scope of most gynecologic surgeons. The overall complete remission rate for 242 patients was 90.4%. The rate for patients who underwent a major surgical procedure was 79.3% compared to 96.7% for patients whose treatment was with chemotherapy alone.The data demonstrate that the integration of surgery in the management of GTD patients often requires a multidisciplinary approach that in many cases can best achieved at specialized treatment centers. ER -