Risk factors for methotrexate resistance in low-risk gestational trophoblastic neoplasia patients (FIGO score 0-4)

科研成果详情

题名	Risk factors for methotrexate resistance in low-risk gestational trophoblastic neoplasia patients (FIGO score 0-4)
作者	Jin, Tianzhe 1; Zhou, Zijun 2; Lin, Mengmeng3; Yuan, Shuo 1; Xue, Yite 1; Yin, Taotao 1; Xu, Ruiyi 1; Chen, Bingxin 1; Zhang, Jianwei 1; Sun, Jiehao2; Li, Xiao 4; Hu, Yan3; Chen, Lili 4,5; Wang, Hui 4
发表日期	2024
发表期刊	AMERICAN JOURNAL OF CANCER RESEARCH 影响因子和分区
语种	英语
原始文献类型	Article
关键词	Gestational trophoblastic neoplasia methotrexate resistance decision tree model choriocarcinoma human chorionic gonadotropin
其他关键词	CANCER ; WOMEN
摘要	The challenge of methotrexate (MTX) resistance among low-risk gestational trophoblastic neoplasia (GTN) patients has always been prominent. Despite the International Federation of Gynaecology and Obstetrics (FIGO) score of 0-4 patients comprising the majority of low-risk GTN patients, a comprehensive exploration of the prevalence and risk factors associated with MTX resistance has been limited. Therefore, we aimed to identify associated risk factors in GTN patients with a FIGO score of 0-4. Between January 2005 and December 2020, 310 low-risk GTN patients received primary MTX chemotherapy in two hospitals, with 265 having a FIGO score of 0-4. In the FIGO 0-4 subgroup, 94 (35.5%) were resistant to MTX chemotherapy, and 34 (12.8%) needed multi-agent chemotherapy. Clinicopathologic diagnosis of postmolar choriocarcinoma (OR = 17.18, 95% CI: 4.64-63.70, P < 0.001) and higher pretreatment human chorionic gonadotropin concentration on a logarithmic scale (log-hCG concentration) (OR = 18.11, 95% CI: 3.72-88.15, P < 0.001) were identified as independent risk factors associated with MTX resistance according to multivariable logistic regression. The decision tree model and regression model were developed to predict the risk of MTX resistance in GTN patients with a FIGO score of 0-4. Evaluation of model discrimination, calibration and net benefit revealed the superiority of the decision tree model, which comprised clinicopathologic diagnosis and pretreatment hCG concentration. The patients in the high- and medium-risk groups of the decision tree model had a higher probability of MTX resistance. This study represents the investigation into MTX resistance in GTN patients with a FIGO score of 0-4 and disclosed a remission rate of approximately 65% with MTX chemotherapy. Higher pretreatment hCG concentration and postmolar choriocarcinoma were independent risk factors associated with resistance to MTX chemotherapy. The decision tree model demonstrated enhanced predictive capabilities regarding the risk of MTX resistance and can serve as a valuable tool to guide the clinical treatment decisions for GTN patients with a FIGO score of 0-4.
资助项目	National Key R&D Program of China [2023YFC2705804]; National Key Research and Development Project of China [2021YFC2701200]; Pioneer, Leading Goose R&D Program of Zhejiang [2022C03013]; Medical and Health Technology Program of Zhejiang Province; [WKJ-ZJ-2113]
出版者	E-CENTURY PUBLISHING CORP
ISSN	2156-6976
卷号	14 期号:3 页码:1353-1362
页数	10
WOS类目	Oncology
WOS研究方向	Oncology
WOS记录号	WOS:001196262900002
收录类别	SCIE
PubMed ID	38590416
通讯作者地址	[Hu, Yan]Wenzhou Med Univ, Affiliated Hosp 1, Dept Gynecol, Wenzhou 325000, Zhejiang, Peoples R China. ; [Chen, Lili;Wang, Hui]Zhejiang Univ, Womens Hosp, Sch Med, Dept Gynecol Oncol, Hangzhou 310006, Zhejiang, Peoples R China.
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/210915
专题	附属第一医院_麻醉科附属第一医院_妇科
通讯作者	Hu, Yan; Chen, Lili; Wang, Hui
作者单位	1.Zhejiang Univ, Womens Hosp, Sch Med, Zhejiang Prov Key Lab Precis Diag & Therapy Major, Hangzhou 310006, Zhejiang, Peoples R China; 2.Wenzhou Med Univ, Affiliated Hosp 1, Dept Anesthesiol, Wenzhou 325000, Zhejiang, Peoples R China; 3.Wenzhou Med Univ, Affiliated Hosp 1, Dept Gynecol, Wenzhou 325000, Zhejiang, Peoples R China; 4.Zhejiang Univ, Womens Hosp, Sch Med, Dept Gynecol Oncol, Hangzhou 310006, Zhejiang, Peoples R China; 5.Zhejiang Prov Clin Res Ctr Obstet & Gynecol, Hangzhou 310006, Zhejiang, Peoples R China
通讯作者单位	附属第一医院_妇科
推荐引用方式 GB/T 7714	Jin, Tianzhe,Zhou, Zijun,Lin, Mengmeng,et al. Risk factors for methotrexate resistance in low-risk gestational trophoblastic neoplasia patients (FIGO score 0-4)[J]. AMERICAN JOURNAL OF CANCER RESEARCH,2024,14(3):1353-1362.
APA	Jin, Tianzhe., Zhou, Zijun., Lin, Mengmeng., Yuan, Shuo., Xue, Yite., ... & Wang, Hui. (2024). Risk factors for methotrexate resistance in low-risk gestational trophoblastic neoplasia patients (FIGO score 0-4). AMERICAN JOURNAL OF CANCER RESEARCH, 14(3), 1353-1362.
MLA	Jin, Tianzhe,et al."Risk factors for methotrexate resistance in low-risk gestational trophoblastic neoplasia patients (FIGO score 0-4)".AMERICAN JOURNAL OF CANCER RESEARCH 14.3(2024):1353-1362.