BACKGROUND: Gestational trophoblastic neoplasia (GTN) is a condition arising from abnormal proliferation of the trophoblastic cells. GTN incidence in Indonesia, precisely in Hasan Sadikin General Hospital, as many as 730 cases are reported per year. GTN is generally highly sensitive to chemotherapy, and multiagent chemotherapy regimens are recommended for high-risk GTN. Multiagent chemotherapy regimens for GTN treatment at Hasan Sadikin General Hospital are EMCO, with no other literature study describing chemotherapy resistance with EMCO today. AIM: This study aimed to identify risk factors associated with first-line chemotherapy resistance at Hasan Sadikin General Hospital. METHODS: In this cross-sectional study, medical records of 81 patients with high-risk GTN presented in the period from January 2018 to June 2021 who received EMCO chemotherapy at Hasan Sadikin General Hospital were retrieved from the archives, and medical data were reviewed and analyzed. Bivariate analysis was performed using the Chi-square test with Fisher’s exact alternative, and multivariate analysis using the binary logistic regression test. p < 0.05 was considered statistically significant. RESULTS: From 81 samples that received EMCO chemotherapy, 15 (18.5%) cases were resistant to EMCO, and 66 (81.5%) cases were responsive to EMCO. The risk factors associated with EMCO resistance were histopathological features and appropriate with EMCO chemotherapy interval (p < 0.05). Variables of age, previous pregnancy, GTN stage, FIGO prognostic score, stage, beta-hCG level, and side effects of EMCO did not significantly correlate with resistance to EMCO (p > 0.05). CONCLUSION: Histopathological features and appropriate chemotherapy intervals were associated with the incidence of resistance to EMCO in Hasan Sadikin General Hospital.

Meneliti perbedaan karakteristik umur, paritas, besar uterus, kadar β-hCG, dan hiperproliferasi pada mola hidatidosa (MH) dengan regresi spontan dan pada MH dengan transformasi keganasan di RS Dr. Hasan Sadikin Bandung. Metode: Penelitian cross sectional deskriptif restrospektif mengambil data umur, paritas, besar uterus, kadar β-hCG pre-evakuasi, dan hiperproliferasi dari rekam medis pasien MH periode 2007-2016. Data diolah menggunakan program SPSS versi 20.0 for Windows. Nilai p<0,05 dianggap signifikan. Hasil: Dari 400 rekam medis yang dianalisis, 233 dengan data lengkap dapat dianalisis. Mayoritas pasien usia reproduktif 20-35(53,6%) tahun, paritas 1-2 (n=90, 38,6%), dan besar uterus rata-rata 19,12±4,633 (~minggu kehamilan). Kadar β-hCG <100000 mIU/mL sebanyak 78(33,5%), ≥100000 mIU/mL sebanyak 155(66,5%). Pasien dengan hiperproliferasi sebanyak 83(35,6%) sedangkan pasien tanpa hiperproliferasi sebanyak 150(64,4%). Terdapat 219(94,0%) dengan komplit MH, dan 14(6,0%) HM parsial (tidak dipublikasi). Pasien kemudian dikategorikan menjadi kelompok transformasi keganasan dan kelompok remisi spontan. Tidak terdapat perbedaan umur, paritas, dan besar uterus diantara dua kelompok (p>0,05). Perbedaan kadar βhCG (mIU/mL) dan tingkat proliferasi menunjukkan hasil signifikan (p<0.05). Kesimpulan: Kadar β-hCG preevakuasi dan status hiperproliferasi dapat digunakan sebagai prediktor transformasi keganasan pasien MH.