The necessity of adjuvant surgery for patients with high-risk chemorefractory or relapsed gestational choriocarcinoma with complete remission after anti-PD-1therapy
- Author:
Jiayuan ZHAO
1
;
Dan WANG
;
Yonglan HE
;
Xirun WAN
;
Jun ZHAO
;
Junjun YANG
;
Yang XIANG
Author Information
- Publication Type:Original Article
- From:Journal of Gynecologic Oncology 2025;36(6):e130-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objective:Anti-programmed cell death protein 1 (PD-1) therapy has demonstrated favorable therapeutic responses in patients with chemorefractory gestational trophoblastic neoplasia.The need for combined surgery to remove resistant foci in patients treated with anti-PD-1 therapy after complete remission (CR), however, has not been investigated. We therefore compared the prognosis of patients with high-risk chemorefractory or relapsed choriocarcinoma who underwent anti-PD-1 therapy with or without surgery.
Methods:Patients with high-risk chemorefractory or relapsed choriocarcinoma who experienced CR following immunotherapy in conjunction with either surgical or non-surgical interventions were selected at Peking Union Medical College Hospital (PUMCH) between August 2018 and December 2023. Study endpoints included progression-free survival (PFS) and overall survival (OS). The results were analyzed using Mann–Whitney U tests and Kaplan–Meier analysis.
Results:Forty-three patients who received andi-PD-1 therapy were enrolled in this study, including 18 patients with surgery and 25 without. Most of the foci in the surgery group were solitary (77.8%). The median maximum diameters of resistant foci before immunotherapy were 2.9 (0.7–7.3) cm and 1.4 (0.8–11.2) cm in the surgery and non-surgery groups, respectively (p=0.184). The 2-year PFS rate was both 91.5% in the non-surgery group and 90.9% in the surgery group. The 2-year and 3-year OS rates were 100.0% in both groups.There was no significant difference in PFS (p=0.849) or OS (p=0.371) between the 2 groups.
Conclusion:These results suggest that surgical resection of drug-resistant lesions may not be necessary in patients with high-risk chemorefractory or relapsed choriocarcinoma who achieve CR after anti-PD-1 therapy.
