Introduction/Background Gestational trophoblastic disease (GTD) constitutes rare group of benign and malignant neoplasia with high cure rates. This study is aimed to evaluate the treatment outcomes in our population
Methodology Retrospective analysis of patients treated with chemotherapy for GTD at King Fahad specialist Hospital Dammam from January 2016 till May 2022. Clinical data were collected from patients electronic files
Results A total of 24 patients with GTD received chemotherapy. Median age was 32 (18–51) years. According to FIGO scoring system, most patients were low-risk (n=21, 87.5%). All patients had histological diagnosis with most common type as complete mole in 13 (54%) patients followed by partial mole (n=7, 29%), choriocarcinoma (n=3, 13%) and epithelioid trophoblastic tumour (n=1, 4%). Median serum BHCG before starting chemotherapy was 54000 (133–949117)mIU/ml. Intramuscular Methotrexate (IM-MTX) was used as a first-line chemotherapy in 20 patients with low-risk disease. It was administered in either weekly (n=9, 45%) or 14 days regimen (n=11, 55%). One patient received actinomycin because of contra-indication to MTX. All (n=3) of the high-risk patients were treated with EMA-CO chemotherapy. Median duration of chemotherapy resulting in normalization of BHCG was 4 (1–16) weeks. Ten (42%) patients had a resistance to IM-MTX and were treated with Actinomycin (n=5) or EMA-CO (n=5) chemotherapy. Median duration for normalization of serum BHCG with second line chemotherapy was 16 (4–22) weeks. Four of 5 patients treated with actinomycin in second line needed EMA-CO chemotherapy as a third line because of the lack of response. All of patients had a complete response to chemotherapy.
Conclusion GTD is a disease of young women. Most were diagnosed with low risk disease and complete mole. Most patients achieved complete response with first line chemotherapy. IM-MTX resistance was noted in 42% patients but achieved a complete response with second- or third-line chemotherapy.
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