TY - JOUR T1 - EP1146 Clinical response to a second uterine curettage in patients with low-risk gestational trophoblastic disease: a pilot study JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer SP - A595 LP - A595 DO - 10.1136/ijgc-2019-ESGO.1187 VL - 29 IS - Suppl 4 AU - F Yarandi AU - E Shir Ali Y1 - 2019/11/01 UR - http://ijgc.bmj.com/content/29/Suppl_4/A595.2.abstract N2 - 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 ER -