Clinical Characteristics of Gestational Trophoblastic Neoplasia: A 15-Year Hospital-Based Study

Sun, Rong; Zhang, Ye; Zheng, Wei; Tian, Quan; An, Ruifang; Xue, Yan

doi:10.1097/igc.0000000000000570

Cited by 6 publications

(5 citation statements)

References 14 publications

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“…Increase in maternal age, which is the most frequently cited risk factor, has a proportional effect on the incidence of post-molar GTN [ 3 , 4 ]. Tow, Savage and Tsukmoto et al [ 5 – 7 ] reported that women greater than 40 years old had a probability of 23-37% of developing persistent GTN after uterine evacuation, while the likelihood in women older than 50 years old was as high as 31-56%.…”

Section: Introductionmentioning

confidence: 99%

Comparison of different therapeutic strategies for complete hydatidiform mole in women at least 40 years old: a retrospective cohort study

2017

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BackgroundThere are three main therapeutic strategies, namely expectant management (dilation and curettage only), prophylactic chemotherapy and prophylactic total hysterectomy for treating older women with complete hydatidiform mole (CHM). However, the scientific community has so far, not unanimously accepted the above-mentioned methods. The objective of this study was to evaluate the effectiveness of these therapeutic strategies in preventing post-molar gestational trophoblastic neoplasia (GTN) pertaining to patients with CHM who were at least 40 years old.MethodsHundred and seventy-one patients from our hospital who had histologically been diagnosed of CHM and underwent treatment from January 2004 to December 2013 were included. All patients were followed continuously for a minimum of 2 years after which relevant clinical data were extracted and analysed.ResultsAll patients were divided to three groups. Group 1 consisted of 124 patients, treated by expectant management, and the incidence of post-molar GTN was 37.1%. Group 2 included 12 patients who received prophylactic chemotherapy, with an incidence of 41.7%. The remaining 35 patients, Group 3, underwent prophylactic total hysterectomy, with the lowest incidence of 11.4%. A significantly lower incidence was noted in group 3 as compared to group 1 (P = 0.004). GTN patients who received prophylactic chemotherapy required, on average, longer time to be diagnosed of GTN and had higher probability of chemotherapy resistance (P = 0.031 and P = 0.024).ConclusionsThis retrospective analysis showed that prophylactic total hysterectomy was the most effective therapeutic strategy for treating CHM in women at least 40 years old of age.Electronic supplementary materialThe online version of this article (10.1186/s12885-017-3749-8) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Comparison of different therapeutic strategies for complete hydatidiform mole in women at least 40 years old: a retrospective cohort study

2017

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“…Since most studies on GTN are based on hospital studies with small samples, it is difficult to estimate their incidence. Compared with Western countries, the incidence of GTN is higher in Southeast Asia and Africa [ 21 , 22 ]. Our hospital is the GTN treatment center in Northwest China.…”

Section: Discussionmentioning

confidence: 99%

“…However, due to non-standard treatment in primary hospitals, there are more cases of chemotherapy resistance. In our previous study, the incidence of invasive mole and CC decreased from 9.0 to 2.7 per 1000 deliveries in 15 years (from 1994 to 2009) [ 22 ]. Despite this continuous decrease, the number of these cases was still higher than in some developed countries [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Features and Demographic Characteristics of Gestational Trophoblastic Neoplasia From A Single Center Experience and SEER Database

Hou¹,

Li²,

Yu³

et al. 2023

Biomol Biomed

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The aim of this study was to analyze the clinical features and demographic characteristics of gestational trophoblastic neoplasia (GTN) patients, specifically choriocarcinoma (CC), placental site trophoblastic tumour (PSTT), and epithelioid trophoblastic tumor (ETT). We utilized data from a local hospital and the SEER database, as well as survival outcomes of CC in SEER database. Additionally, we used multiple risk factors to create a prognostic nomogram model for CC patients. The study included GTN patients from the SEER database between 1975 and 2016 as well as those from the First Affiliated Hospital of Xi 'an Jiaotong University between January 2005 and May 2022. Related factors of patients were compared using the chi-square (χ2) or Fisher's exact test. For assessing overall survival we employed the Kaplan-Meier method and log-rank test. To construct the nomogram, we used Cox regression. Statistically significant differences were found between CC and PSTT/ETT patients in terms of surgery in local hospital, as well as age and year of diagnosis in the SEER database. Moreover, significant differences were observed between low and high (HR) /ultra-high risk (UHR) groups regarding FIGO stage, surgery and chief complaint at the local hospital, and FIGO stage, surgery and unemployment in the SEER database. The Cox regression analysis confirmed that age, race, surgery, marital status, FIGO stage, and unemployment were correlated with CC prognosis. Furthermore, the analysis showed that patients aged 40 years or older and those with FIGO Ⅲ/Ⅳ were independent prognostic factors of CC. The study indicates that atypical symptoms or signs may be the main reasons for HR /UHR patients to seek medical treatment. Therefore, providing multidisciplinary care is recommended for CC patients experiencing psychological distress due to unfavorable marital status or unemployment.

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“…Maternal age of ≥40 years increases the HM risk to 5–10 times, 3 like the risk of GTN following abortion. 4 5 6 According to Savage, et al, 7 while the complete molar pregnancy rate at ages 14–40 years is <1/1000 pregnancies, the rate rises to about 1/156 pregnancies at age 45 and is very high in older women aged ≥50 years, at about 1/8 pregnancies. The rate of developing GTN after abortion also rises with age, specifically around 23%–37% in women aged ≥40 years, whilst it is very high in women >50 years at about 31%–56%.…”

Section: Introductionmentioning

confidence: 99%

Clinical Features of Gestational Trophoblastic Disease in Aged Women in South Vietnam

Nguyen

Phan

et al. 2023

Yonsei Med J

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Purpose This study aimed to determine the occurrence rate of gestational trophoblastic neoplasia (GTN) and its related factors in aged women with hydatidiform mole (HM) in Tu Du Hospital, Vietnam. Materials and Methods This retrospective cohort study included 372 women aged ≥40 years with HM diagnosed through post-abortion histopathological assessment in Tu Du Hospital from January 2016 to March 2019. Survival analysis was used for GTN cumulative rate estimation, log-rank test for group comparison, and Cox regression model for determining GTN-related factors. Results After a 2-year follow-up, 123 patients were found to have GTN at a rate of 33.06% [95% confidence interval (CI): 28.30–38.10]. GTN occurrence meant that the time was 4.15±2.93 weeks with peaks at week 2 and 3 after curettage abortion. The GTN rate was remarkably higher in the ≥46-year age group than in the 40-to-45-year age group [hazard ratio (HR)=1.63; 95%CI: 1.09–2.44], as was the vaginal bleeding group compared to the non-bleeding group (HR=1.85; 95%CI: 1.16–2.96). Preventive hysterectomy and preventive chemotherapy plus hysterectomy in the intervention group reduced the GTN risk compared to the no intervention group at HRs of 0.16 (95%CI: 0.09–0.30) and 0.09 (95%CI: 0.04–0.21), respectively. Chemoprophylaxis failed to decrease the GTN risk when comparing the two groups. Conclusion Post-molar pregnancy GTN rate in aged patients was 33.06%, much higher than that of the general population. Preventive hysterectomy or chemoprophylaxis plus hysterectomy are effective treatment methods to support GTN risk reduction.

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Clinical Characteristics of Gestational Trophoblastic Neoplasia: A 15-Year Hospital-Based Study

Cited by 6 publications

References 14 publications

Comparison of different therapeutic strategies for complete hydatidiform mole in women at least 40 years old: a retrospective cohort study

Comparison of different therapeutic strategies for complete hydatidiform mole in women at least 40 years old: a retrospective cohort study

Clinical Features and Demographic Characteristics of Gestational Trophoblastic Neoplasia From A Single Center Experience and SEER Database

Clinical Features of Gestational Trophoblastic Disease in Aged Women in South Vietnam

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