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EP1146 Clinical response to a second uterine curettage in patients with low-risk gestational trophoblastic disease: a pilot study
  1. F Yarandi and
  2. E Shir Ali
  1. Teharn University of Medical Scienceis, Tehran, Islamic Republic of Iran


Introduction/Background To determine the curative effect of a repeat uterine evacuation in patients with low-risk gestational trophoblastic neoplasia.

Methodology Patients with low-risk gestational trophoblastic neoplasia (GTN)(N=12), diagnosed according to the International Federation of Gynecology and Obstetrics 2002 guidelines, were enrolled in a prospective cohort study. Primary outcomes were need for chemotherapy after second uterine evacuation and number of chemotherapy courses needed to achieve complete remission.

Results Ten patients (83%) did not require chemotherapy and were cured bya second curettage. Two patients failed to respond to the second curettage and received single-agent chemotherapy with actinomycin-D (1.25 mg/m2 biweekly, slow intravenous administration). Both patients responded to chemotherapy as second-line therapy. A 100% remission rate was achieved, with no recurrence at the 1-year follow-up. One patient (8%) had a uterine perforation.

Conclusion Second curettage has a favorable response rate. It seems reasonable to perform a second curettage in patients with low-risk GTN in settings where serum beta-hCG assay follow-up is highly reliable and available. However, its potential complications and inconvenience must be discussed critically with each patient.

Disclosure Nothing to disclose

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