RT Journal Article SR Electronic T1 Complete Resection Is Essential in the Surgical Treatment of Gestational Trophoblastic Neoplasia JF International Journal of Gynecologic Cancer JO Int J Gynecol Cancer FD BMJ Publishing Group Ltd SP 1453 OP 1460 DO 10.1097/IGC.0000000000001348 VO 28 IS 8 A1 Essel, Kathleen Gong A1 Shafer, Aaron A1 Bruegl, Amanda A1 Gershenson, David M. A1 Drury, Lane K. A1 Ramondetta, Lois M. A1 Naumann, R. Wendel A1 Brown, Jubilee YR 2018 UL http://ijgc.bmj.com/content/28/8/1453.abstract AB Objective The aim of this study was to determine the utility of surgery in patients with gestational trophoblastic neoplasia (GTN).Materials and Methods We performed a retrospective institutional review board–approved analysis of all patients with GTN at a single institution from 1985 to 2015 and compared all patients who underwent surgery as definitive management for their disease to a matched cohort of those who did not. Kaplan-Meier curves were used to estimate progression-free survival (PFS) and overall survival (OS).Results Sixty-nine patients underwent a total of 94 surgeries as definitive treatment for GTN. Nineteen patients had multiple surgeries. Progression-free survival and OS were improved in patients with complete macroscopic surgical resection (n = 61) compared with patients with gross residual disease (n = 33) (median PFS 91.2 months vs 3.3 months, and median OS not reached at 108.8 months vs 66.3 months, respectively; P < 0.05). The nature of the surgery (emergent vs planned) and site of metastatic disease did not influence PFS or OS. Of the 61 patients with no visible residual disease, 17 received adjuvant chemotherapy and 44 did not; there were no observed differences in PFS or OS. Patients who underwent surgery as part of definitive treatment (n = 69 patients) were compared with patients with GTN over the same period who received chemotherapy alone (n = 33 patients). Median PFS was improved in the surgical group (5.9 vs 5.1 months, P < 0.01), but OS was not significantly different (P = 0.37).Conclusions Complete resection results in improved outcomes in patients who undergo surgery for GTN, whether emergent or planned, independent of disease site, and should be considered as an important component of treatment in some situations.