Article Text
Abstract
Introduction/Background Gestational trophoblastic neoplasia (GTN) is a rare disease with myriad presentations. The long-term outcomes of these patients were studied.
Methodology This was a single institution retrospective study in a tertiary care cancer centre in India All patients diagnosed with GTN from January 2009 to December 2014 were evaluated. Data was retrieved from case files and electronic medical records.
Results Total of 139 patients were evaluated. The median age of presentation was 27 years (range 18–54 years). The median β HCG was 53726 IU/ml (Range 18 to 10440587). Most patients (n=119, 86%) belonged to low socioeconomic strata. Forty-four per cent (n=61) of the patients were in the WHO low-risk group and 53% (n=73) were high-risk group, this included 25 patients with ultra-high risk, data for stage was missing for 5 patients. In the low-risk group, 90% (n=54) were treated with single-agent Methotrexate. In this group DFS and OS at 10 years was 95% - 95 CI (89% - 100%), 97% -95% CI (92% to 100%) respectively. High risk group was treated with multiagent chemotherapy most commonly EMACO (n=68, 93%). Induction EP was received by 9 patients. The DFS and OS at 10 years were 81% - 95% CI (72% TO 91%) and 85% - 95% CI (76% TO 94%) respectively. In the entire cohort 44 patients were desirous of pregnancy and 24 of them conceived in due course. There were a total of 11 deaths, due to acute bleed in 5 (in 3 in spite of the use of induction EP) and progressive disease in 6 patients 4 of whom had brain and 2 had liver metastasis in addition lung metastasis.
Conclusion Though, most patients with GTN have long term cure with preserved reproductive function, it is important to prevent early induction mortality.
Disclosures Nil