Surgical Management for Resistant Gestational Throphoblastic Neoplasia: Yogyakarta Experience

Greta S Gulo (Department of Obstetrics and Gynecology, Medical School of Gadjahmada University-Sardjito Teaching Hospital, Yogyakarta, Indonesia)
Nirwan Darmawan (Department of Obstetrics and Gynecology, Medical School of Universitas Gadjah Mada - Dr Sardjito General Hospital, Yogyakarta, Indonesia)
Bob Irsan (Department of Obstetrics and Gynecology, Medical School of Universitas Gadjah Mada - Dr Sardjito General Hospital, Yogyakarta, Indonesia)
Wisnu Prabowo (Department of Obstetrics and Gynecology, Medical School of Universitas Gadjah Mada - Dr Sardjito General Hospital, Yogyakarta, Indonesia)
Ardhanu Kusumanto (Oncology and Gynaecology subdivision, Department of Obstetrics and Gynecology, Medical School of Universitas Gadjah Mada - Dr Sardjito General Hospital, Yogyakarta, Indonesia)

Journal of the Medical Sciences (Berkala Ilmu Kedokteran)
Vol 50, No 1 (2018): SUPPLEMENT

Gestational trophoblastic neoplasia (GTN) is a highly responsive to chemotherapy, but sometimes can be resistant, or relapse and require salvage chemotherapy with or without surgery.  We use descriptive studies with case series to determine prognosis patient GTN with chemotherapy resistant manage with surgical procedure in Sardjito Hospital, Yogyakarta. GTN-resistant chemotherapy patients that undergoing hysterectomy showed significant decreases in hCG levels. Hysterectomy also help us to stop vaginal bleeding. However, complications from continuous bleeding can worsen patient condition. The decision to take a hysterectomy action varies depending on the patient's condition. At the Sardjito hospital, the patient was diagnosed with the fastest hysterectomy within the first 12 hours of treatment due to continuous bleeding, and shortly after 4 years of treatment with 5 different types of chemotherapy.