Regional perspectives on gestational trophoblastic disease in Turkey

Studies in Turkey are hospital based, and there is a wide variation in reported incidences that necessitate population based-studies to determine the real incidence of gestational trophoblastic diseases (GTDs). According to hospital-based studies, the frequency of GTD is generally very high and there are also regional differences. Epidemiologic study was performed to determine the frequency of hydatidiform mole (HM) in a rural part of Turkey. According to this study, the frequency of HM was lower than the frequencies reported by most of the hospital-based studies. In a national study, an inquiry form related to the approach to GTD was sent to obstetrics and gynecology departments. According to this study, a clinical classification system was used for gestational trophoblastic neoplasia by 60% of the hospitals. Methotrexate was the single-agent chemotherapy used most frequently. With regard to first-line combined chemotherapy, MAC (methotrexate, actinomycin, chlorambucil) was the preferred combination. EMA-CO (etoposide, methotrexate, actinomycin D, cyclophosphamide, Oncovin) was the most commonly used second-line chemotherapeutic regimen. From more recent studies, EMA-CO is the first-line combination chemotherapy. There is no national registry system for GTD in Turkey. There appears to be a need to conduct properly designed community-based studies with well-established case registry system in Turkey.