Introduction/Background Gestational trophoblastic neoplasia (GTN) is a rare potential curable malignancy that consists of abnormal proliferation of trophoblastic tissue following a hydatiform mole or a nonmolar pregnancy. Both a stage and a risk score are determined at baseline to help decide the best treatment. We aimed to review all cases of histologically diagnosed GTD, focusing on GTN.
Methodology Retrospective analysis of all GTD cases diagnosed at our institution since 1996.
Results A total of 101 GTD cases were identified, divided by histological subtypes as follows: 46 complete hydatiform moles, 34 partial hydatiform moles, 12 invasive moles (IM) and 9 choriocarcinomas (CC). Median age at diagnosis was 31 years. Regarding GTN (CC and IM, 21 cases), 4 cases were treated at another hospital and so excluded from this analysis. Of the remaining 17 cases, 12 were stratified as low risk and 5 as high risk according to modified WHO prognostic scoring system. Most (9 cases) had stage III by FIGO staging. All low risk cases (12) were treated with single agent methotrexate (MTX) (median of 6.5 cycles) and 4 non-responders had a second line chemotherapy (ChT) with dactinomycin with complete response (CR). None of these low risk patients had disease relapse. Regarding high risk cases (5), 3 were treated with first line MTX (4, 8 and 10 ChT cycles) followed by second line dactinomycin (10, 5, 8 ChT cycles respectively), 2 with CR and 1 progressed to third-line EMA/CO (ongoing). The remaining 2 high risk cases were treated with EMA/CO (3 and 8 ChT cycles), one of them retreated after 7 years. All patients are alive.
Conclusion As expected GTN is a rarer condition than non-invasive moles. Despite its invasive nature shows a very good prognosis after treatment with ChT. Sequential single-agent ChT should be studied as an option even in high risk patients.
Disclosure Nothing to disclose
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