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EP1142 Gestational trophoblastic neoplasia: clinical presentation, treatment and outcomes
  1. S Tangjitgamol and
  2. S Srijaipracharoen
  1. Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand


Introduction/Background To assess clinical and pathologic features of patients with gestational trophoblastic neoplasia (GTN), treatment and oncologic outcomes.

Methodology Patients with GTN who had clinical data in our institution were identified. Data collected were age at GTN diagnosis, preceding pregnancy and interval, FIGO stage and WHO score, treatment and oncologic outcomes after treatment.

Results From 115 patients, 73 with available data were included in the study. Median age at GTN diagnosis was 32.8 years (range, 17–52 years). The most common antecedent pregnancy was molar pregnancy (85.1%). Stage I disease was most common (74.3%) followed by stage III (23.0%) and stage IV (4.0%). According to the WHO score, 85.1% were classified as low risk, 10.8% as high risk, and 4.1% as ultra-high risk. All patients with metastasis had pulmonary lesions. Other metastatic sites were brain, abdominal wall, vulva, and colon. Surgery was performed in 27.0% as resection of lesions, primary or secondary hysterectomy prior to or after few cycles of chemotherapy respectively. Chemotherapy was given in 94.6% of patients, with methotrexate as the most common first-line chemotherapy (75.0%). Response rate was 86.3%. The patients who had persistence or rising of serum hCG (13.7%) as well as those who experienced side-effects from first-line chemotherapy (4.1%) or recurrence (6.8%) had second-line chemotherapy. After a median follow-up of 22.7 months (range, 0.37–210.9 months), only 1 patient was dead from progressive diseases in brain and lung at 15.1 months after GTN after diagnosis. Two patients with ultra-high risk or recurrence diseases were still in the course of chemotherapy treatment. The others were alive and doing well without any evidences of diseases.

Conclusion Majority of GTN had antecedent molar pregnancy, stage I and low risk disease. Surgery had certain role in selected patients. Chemotherapy was the mainstay of treatment yielding good oncologic outcomes.

Disclosure Nothing to disclose

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