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Management of Molar-Pregnancy and Associated Gestational Trophoblastic Neoplasia at a Specialised Unit: 10-Year
Harrison Odgers1,2, Shannon Philp1,3, Trevor Tejada-Berges1,2
1Department of Gynaecologic Oncology, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.
Patients diagnosed with gestational trophoblastic diseases (GTD) can develop malignant gestational trophoblastic neoplasia (GTN). ß-hCG monitoring is important in the early detection of GTN. The primary outcome of this study was to describe ß-hCG monitoring completion rates and time from GTN diagnosis to chemotherapy commencement for patients cared for by a specialised GTD unit within a Gynecologic Oncology department. Secondary outcomes included imaging findings, quantitative ß-hCG levels and gestational age at the time of GTD diagnosis, WHO/FIGO scores and chemotherapy outcomes for those who developed GTN, and the time taken for ß-hCG normalisation for both groups. We collected data for 164 patients with molar pregnancies and 28 patients with GTN requiring chemotherapy. ß-hCG monitoring completion was 93.9%, and the median time to chemotherapy commencement was 7 days. Additional data found a low risk of GTN diagnosis following a negative ß-hCG and high complete response rates to chemotherapy for GTN.
Patients diagnosed with gestational trophoblastic diseases (GTD) can develop malignant gestational trophoblastic neoplasia (GTN). ß-hCG monitoring is important in the early detection of GTN. The primary outcome of this study was to describe ß-hCG monitoring completion rates and time from GTN diagnosis to chemotherapy commencement for patients cared for by a specialised GTD unit within a Gynecologic Oncology department. Secondary outcomes included imaging findings, quantitative ß-hCG levels and gestational age at the time of GTD diagnosis, WHO/FIGO scores and chemotherapy outcomes for those who developed GTN, and the time taken for ß-hCG normalisation for both groups. We collected data for 164 patients with molar pregnancies and 28 patients with GTN requiring chemotherapy. ß-hCG monitoring completion was 93.9%, and the median time to chemotherapy commencement was 7 days. Additional data found a low risk of GTN diagnosis following a negative ß-hCG and high complete response rates to chemotherapy for GTN.
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