Taiwanese Journal of Obstetrics and Gynecology
Volume 44, Issue 2 , Pages 139-142, June 2005

Experience in Treatment of Patients with Gestational Trophoblastic Disease

  • William R. Bell

      Affiliations

    • Division of Hematology, Department of Internal Medicine, Chung Shan Medical University Hospital, and The Johns Hopkins University School of Medicine, Department of Medicine, Division of Hematology, Baltimore, Maryland, USA

Department of Obstetrics and Gynecology, Chung Shan Medical University and Hospital, Taichung, Taiwan, Baltimore, Maryland, USA

Received 11 October 2004; received in revised form 20 October 2004; accepted 27 October 2004.

Article Outline

Summary 

Objective

To determine outcome in patients with hydatidiform mole and gestational trophoblastic tumor after successful treatment.

Materials and Methods

This was a retrospective review of outcome in 22 patients with gestational trophoblastic disease (GTD) who completed human chorionic gonadotropin (hCG) follow-up for 1 year or more after treatment between 1999 and 2003.

Results

The mean age of patients with GTD was 32.5 years. Sixteen patients (72.7%) with hydatidiform mole and six (27.3%) with gestational trophoblastic tumor were evaluated. One patient (4.5%) with metastatic choriocarcinoma experienced complete remission after debulking surgery followed by chemotherapy. Fifteen patients (68.2%) with persistent GTD were diagnosed by hCG follow-up. After at least 1 year, eight patients (36.4%) conceived and six (27.3%) delivered a healthy term baby. All patients experienced an excellent prognostic outcome following chemotherapy and there were no deaths.

Conclusion

GTD exhibited an excellent response to chemotherapy and subsequent successful pregnancy was achieved in some patients 1 year or more after completion of treatment. Patients without previous childbirth desired subsequent pregnancy. Patients must be followed-up carefully after treatment and during conception.

Key Words:  chemotherapy , gestational trophoblastic disease , metastatic choriocarcinoma , subsequent pregnancy

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Grimes DA . Epidemiology of gestational trophoblastic disease . Am J Obstet Gynecol . 1984;150:309–318
  2. Gougeon A . Regulation of ovarian follicular development in primates: facts and hypothesis . Endocr Rev . 1996;17:121–151
  3. Kohorn EI , Goldstein DP , Hancock BW , et al.   Workshop Report: Combining the staging system of the International Federation of Gynecology and Obstetrics with the scoring system of the World Heath Organization for Trophoblastic Neoplasia. Report of the Working Committee of the International Society for the Study of Trophoblastic Disease and the International Gynecologic Cancer Society . Int J Gynecol Cancer . 2000;10:84–88
  4. Newlands ES , Bagshawe KD , Begent RHJ , Rustin GJ , Holden L . Results with EMA/CO (etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine) regimen in high risk gestational trophoblastic tumors, 1979–1989 . Br J Obstet Gynaecol . 1991;96:550–557
  5. Greenfield AW . Gestational trophoblastic disease: prognostic variables and staging . Semin Oncol . 1995;22:142–148
  6. Bagshawe RS , Dent J , Webb J . Hydatidiform mole in the United Kingdom 1973–1983 . Lancet . 1986;2:673–677
  7. Lurain JR , Brewer JI , Torok EE , Halpern B . Natural history of hydatidiform mole after primary evacuation . Am J Obstet Gynecol . 1983;145:591–595
  8. Matsui H , Iitsuka Y , Suzuka K , Yamazawa K , Seki K , Sekiya S . Outcome of subsequent pregnancy after treatment for persistent gestational trophoblastic tumour . Hum Reprod . 2002;17:469–472
  9. Tuncer ZS , Bernstein MR , Goldstein DP , Lu KH , Berkowitz RS . Outcome of pregnancies occurring within 1 year of hydatidiform mole . Obstet Gynecol . 1999;94:588–590
  10. Lan Z , Song H , Yang X , Xiang Y . Pregnancy outcomes of patients who conceived within 1 year after chemotherapy for gestational trophoblastic tumor: a clinical report of 22 patients . Gynecol Oncol . 2001;83:146–148

PII: S1028-4559(09)60125-X

doi:10.1016/S1028-4559(09)60125-X

Taiwanese Journal of Obstetrics and Gynecology
Volume 44, Issue 2 , Pages 139-142, June 2005

Article Tools