Response to Chemotherapy in Patients with Gestational Trophoblastic Neoplasia in A Tertiary Hospital in Indonesia

Farisa Raudina, Yudi Mulyana Hidayat, Sylvia Rachmayati

Abstract


Background: The incidence of gestational trophoblastic neoplasia (GTN) is high in Indonesia. Based on the FIGO prognostic score, GTN is classified into low-risk and high-risk categories. The high-risk group requires multidrug chemotherapy whereas the low-risk group requires single-drug chemotherapy. Response to chemotherapy would reflect the remission rate. The aim of this study was to describe the response to chemotherapy in GTN patients

Methods: This was a cross-sectional descriptive retrospective study on medical records of patients with GTN treated in Dr. Hasan Sadikin General Hospital during the period of 2016 to 2018. The inclusion criteria were GTN patients who received > 3 cycles of chemotherapy while the exclusion criteria were incomplete, inaccessible, or missing data. Data were collected on patient’s age, parity, history of previous pregnancy, pregnancy-therapy interval, tumor size, number and location of metastases, and history of failed chemotherapy.

Results: Of the189 medical records of the GTN patient collected, only 88 met the inclusion criteria, (63.6% low risk and 36.4% high risk). Most patients were responsive to chemotherapy (61.4%), aged<40 years old, multiparity, tumor size >5 cm, had 4 month interval from previous pregnancy <4 months, had a history of molar pregnancy, had no metastases, and no previous failed chemotherapy.

Conclusion: The chemotherapy response in gestational trophoblastic neoplasm patients is fairly good with most patients are in the low-risk groups. Specific tumor markers used in early diagnosis of GTN may play a major role.


Keywords


FIGO, prognostic score, gestational trophoblastic neoplasia, remission rate

Full Text:

PDF

References


Jagtap SV, Aher V, Gadhiya S, Jagtap SS. Gestational trophoblastic disease - Clinicopathological study at tertiary care hospital. J Clin Diagnostic Res. 2017;11(8):EC27–30.

Cunningham FG. Williams obstetrics. 24th ed. McGraw-Hill Education; 2015. 1358 p.

Brown J, Naumann RW, Seckl MJ, Schink J. 15years of progress in gestational trophoblastic disease: Scoring, standardization, and salvage. Gynecol Oncol. 2017;144(1):200–7.

Ngan HYS, Kohorn EI, Cole LA, Kurman RJ, Kim SJ, Lurain JR, et al. Trophoblastic disease. Int J Gynecol Obstet. 2012;119:S130–6.

Hoffman BL, Schorge JO, Bradshaw KD, Halvorson LM, Schaffer JI, Corton MM. Williams gynecology.2015.1270 p.

Froeling FEM, Seckl MJ. Gestational Trophoblastic Tumours: An Update for 2014. Curr Oncol Rep. 2014;16(11).

Gestational Trophoblastic Neoplasia Union for International Cancer Control 2014 Review of Cancer Medicines on the WHO List of Essential Medicines G.2014;1–3

Departemen/KSM Obstetri dan Ginekologi. Laporan Tahunan 2018. FK UNPAD RSUP DR. Hasan Sadikin. 2018.

Ngan HYS, Seckl MJ, Berkowitz RS, Xiang Y, Golfier F, Sekharan PK, et al. Update on the diagnosis and management of gestational trophoblastic disease. Int J Gynecol Obstet. 2018;143:79–85.

Kong Y, Yang J, Jiang F, Zhao J, Ren T, Li J, et al. Clinical characteristics and prognosis of ultra high-risk gestational trophoblastic neoplasia patients: A retrospective cohort study. Gynecol Oncol. 2017;146(1):81–6.

Santaballa A, García Y, Herrero A, Laínez N, Fuentes J, De Juan A, et al. SEOM clinical guidelines in gestational trophoblastic disease (2017). Clin Transl Oncol. 2018;20(1):38–46.

Chapman-Davis E, Hoekstra A V., Rademaker AW, Schink JC, Lurain JR. Treatment of nonmetastatic and metastatic low-risk gestational trophoblastic neoplasia: Factors associated with resistance to single-agent methotrexate chemotherapy. Gynecol Oncol. 2012;125(3):572–5.

Li J, Yang J, Liu P, Ren T, Zhao J, Feng F, et al. Clinical characteristics and prognosis of 272 postterm choriocarcinoma patients at Peking Union Medical College Hospital: A retrospective cohort study. BMC Cancer [Internet]. 2016;16(1):1–8.

Foster BR, Elsayes KM, Menias CO, Shaaban AM, Salama ME, Olpin JD, et al. Gestational Trophoblastic Disease: Clinical and Imaging Features. RadioGraphics. 2017;37(2):681–700.

Litkouhi B, Al-Khan A. Gestational trophoblastic disease. Oper Obstet Fouth Ed. 2017;376(9742):523–33.

Alazzam M, Tidy J, Osborne R, Coleman R, Hancock BW, Lawrie TA. Chemotherapy for resistant or recurrent gestational trophoblastic neoplasia. Cochrane Database Syst Rev. 2016;2016(1).

Mousavi AS, Zamani A, Khorasanizadeh F, Gilani MM, Zendehdel K. Resistance to single-agent chemotherapy and its risk factors in low-risk gestational trophoblastic neoplasms. J Obstet Gynaecol Res. 2015;41(5):776–83.

May T, Goldstein DP, Berkowitz RS. Current Chemotherapeutic Management of Patients with Gestational Trophoblastic Neoplasia. Chemother Res Pract. 2011;2011:1–12.




DOI: https://doi.org/10.15850/amj.v7n3.1894

Article Metrics

Abstract view : 869 times
PDF - 562 times



 This Journal indexed by

                  

          

 

Creative Commons License
AMJ is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

 


View My Stats