Article Text
Abstract
Introduction/Background Gestational trophoblastic diseases encompass a range of placental pathologies, of which gestational trophoblastic tumours (GTT) are one. GTTs are a rare and malignant entity impacting young women seeking to conceive. In this GTT study, our two objectives are: to evaluate compliance with the international federation of gynaecology and obstetrics 2000 (FIGO 2000) recommendations for GTT diagnosis and management, while analysing the efficacy-toxicity ratio of recommended treatments, and to assess surgery utilization in patients.
Methodology We conducted a retrospective study over a period of 15 years, from January 2009 until October 2023. All cases of GTT that were followed up in the Obstetrics and Gynaecology II Department of the Hassan II University Hospital in Fez-Morocco were included.
Results Fifty-two cases of GTT were registered. The mean age was 36 years. The diagnostic criteria for GTT in all patients were those recommended by FIGO 2000. Abnormal evolution in gonadotrophic chorionic hormone levels, following molar aspiration, and metrorrhagia revealed GTT in 54% and 34.6% of cases, respectively. Among our patients, 27% had metastasis. According to FIGO 2000, 34.6% of our patients were scored at high risk. All patients scored at low risk received methotrexate mono-chemotherapy except for one case where Actinomycin D was utilized. High-risk patients underwent polychemotherapy. Total inter-adnexal hysterectomy was performed on 11 patients: for haemostatic purpose in 4 cases, for tumour mass reduction in 2 cases and in 5 cases where the patients had completed their parental project. Major complications, especially haematological, were observed in 25% of patients undergoing chemotherapy. We report a single death caused by chemo-induced acute leukaemia.
Conclusion Chemotherapy has significantly enhanced the prognosis of patients with GTT. Nonetheless, more attention must be paid to provide psychological support to these patients as we have observed their reluctance to conceive following GTT.
Disclosures All authors declare no conflicts of interest. This study did not receive any funding.