Gestational Trophoblastic Neoplasia
Bibliographic record
Abstract
OBJECTIVE: To report the results of treatment of gestational trophoblastic neoplasia (GTN) at the John I. Brewer Trophoblastic Disease Center over the past 28 years, compare the outcomes to those from the first 16 years, and analyze factors affecting response to treatment and survival. METHODS: We reviewed the records of 408 patients with GTN (excluding placental-site tumors) treated at the Brewer Center from 1979 to 2006. Outcomes and prognostic factors were analyzed and compared with those for the 396 patients treated at the Brewer Center from 1962 to 1978. RESULTS: The overall survival rate in 804 patients with GTN treated from 1962 to 2006 was 93.3% (88.6% from 1962 to 1978 and 97.8% from 1979 to 2006). All 491 patients with nonmetastatic disease treated during both time periods were cured; however, the cure rate for patients with metastatic disease increased from 77.8% (158 of 203) during 1962-1978 to 91.8% (101 of 110) during 1979-2006. Factors determined to significantly influence resistance to initial chemotherapeutic treatment on multivariable analysis from 1979 to 2006 were 1) presence of metastatic compared with nonmetastatic disease (41% compared with 12%; odds ratio [OR] 0.21, 95% confidence interval [CI] 0.13-0.35); 2) metastatic site other than the lung or vagina (76% compared with 31%; OR 0.05, 95% CI 0.02-0.13); 3) prior unsuccessful chemotherapy at another institution compared with primary treatment at our center (63% compared with 17%; OR 0.11, 95% CI 0.05-0.22); and 4) duration of disease greater than 4 months compared with 4 months or less (35% compared with 17%; OR 0.38, 95% CI 0.21-0.66). CONCLUSION: The overall survival rate in patients with GTN treated at the Brewer Center improved from 88.6% in 1962-1978 to 97.8% in 1979-2006.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".