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Updated: Jun 26, 2026
Microsatellite DNA Genotyping and Flow Cytometry Ploidy Analyses of Formalin-fixed Paraffin-embedded Hydatidiform Molar Tissues
Published on: October 20, 2019
Gestational Trophoblastic Neoplasia Following Hydatidiform Mole and Non-Molar Pregnancy: Clinical and Prognostic
Elza Maria Hartmann Uberti1, Lidia Rosi de Freitas Medeiros1, Rodrigo Bernardes Cardoso1,2
1Gestational Trophoblastic Disease Center, Department of Obstetrics and Gynecology, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre 90035-074, RS, Brazil.
Background:
Gestational trophoblastic neoplasia (GTN) is rare but highly curable. This study compared clinical characteristics and outcomes between molar and non-molar disease.
Methods:
This retrospective cohort included 550 patients at a Brazilian reference center (1985-2025). Survival was assessed using Kaplan-Meier methods. Multivariable analyses included Poisson and Cox regression models.
Results:
Molar GTN comprised 86% of cases. Non-molar GTN (14%) presented with more advanced FIGO stages, higher WHO risk scores, and more metastases (p < 0.001). Overall five-year disease-specific survival (DSS) was 97.4% (95% CI 95.9-98.9) and progression-free survival (PFS) was 92.4% (95% CI 90.1-94.7). Non-molar disease had lower DSS (84.4% vs. 99.8%; p < 0.001) and PFS (85.3% vs. 93.5%; p = 0.049) in unadjusted analyses. However, after multivariable adjustment, GTN type was not independently associated with DSS (HR 9.41; 95% CI 0.70-127; p = 0.092) or PFS (HR 1.61; 95% CI 0.57-4.60; p = 0.372). Non-molar patients had a lower likelihood of subsequent pregnancy (RR 0.60; 95% CI 0.36-1.00; p = 0.049).
Conclusions:
Although non-molar GTN presents with more aggressive clinical features, survival outcomes appear to be primarily driven by baseline disease severity rather than GTN subtype itself.
