Characteristics of gestational thropoblast tumor in Dr. Soetomo Hospital,  year 2015-2017

Angelina, Yoan Alexandria; Hartono, Poedjo

doi:10.20473/mog.v27i22019.79-83

Cited by 2 publications

(2 citation statements)

References 5 publications

(5 reference statements)

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“…In a different study, chemotherapy-resistant patients have a more extended treatment duration than the complete response to EMACO. In that particular study, there was no significant difference between the initial beta-hCG levels between the resistant and the non-resistant groups [15], [16].…”

Section: Discussionmentioning

confidence: 67%

Risk Factors That Correlate with Resistance to First-Line Chemotherapy on High-risk Gestational Trophoblastic Neoplasia

Kurniadi

Zulvayanti²,

Suardi³

et al. 2022

Open Access Maced J Med Sci

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BACKGROUND: Gestational trophoblastic neoplasia (GTN) is a condition arising from abnormal proliferation of the trophoblastic cells. GTN incidence in Indonesia, precisely in Hasan Sadikin General Hospital, as many as 730 cases are reported per year. GTN is generally highly sensitive to chemotherapy, and multiagent chemotherapy regimens are recommended for high-risk GTN. Multiagent chemotherapy regimens for GTN treatment at Hasan Sadikin General Hospital are EMCO, with no other literature study describing chemotherapy resistance with EMCO today. AIM: This study aimed to identify risk factors associated with first-line chemotherapy resistance at Hasan Sadikin General Hospital. METHODS: In this cross-sectional study, medical records of 81 patients with high-risk GTN presented in the period from January 2018 to June 2021 who received EMCO chemotherapy at Hasan Sadikin General Hospital were retrieved from the archives, and medical data were reviewed and analyzed. Bivariate analysis was performed using the Chi-square test with Fisher’s exact alternative, and multivariate analysis using the binary logistic regression test. p < 0.05 was considered statistically significant. RESULTS: From 81 samples that received EMCO chemotherapy, 15 (18.5%) cases were resistant to EMCO, and 66 (81.5%) cases were responsive to EMCO. The risk factors associated with EMCO resistance were histopathological features and appropriate with EMCO chemotherapy interval (p < 0.05). Variables of age, previous pregnancy, GTN stage, FIGO prognostic score, stage, beta-hCG level, and side effects of EMCO did not significantly correlate with resistance to EMCO (p > 0.05). CONCLUSION: Histopathological features and appropriate chemotherapy intervals were associated with the incidence of resistance to EMCO in Hasan Sadikin General Hospital.

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Section: Discussionmentioning

confidence: 67%

Risk Factors That Correlate with Resistance to First-Line Chemotherapy on High-risk Gestational Trophoblastic Neoplasia

Kurniadi

Zulvayanti²,

Suardi³

et al. 2022

Open Access Maced J Med Sci

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“…This condition usually occurs after a previous pregnancy with a history of miscarriage and an ectopic or molar pregnancy. 1 Guidelines from the International Federation of Gynecology and Obstetrics (FIGO) are used to guide treatment decisions. 2 Patients with a FIGO score ≤ 6 should be treated with single agent chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

EMA and EMACO Chemotherapy in High Risk Gestational Trophoblast Disease, which Better?

Winata

Aricandana

2022

Indones J Obstet Gynecol

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Abstract Objective: Determine the best effectiveness and efficacy between EMA and EMACO for patients with high-risk GTN. Results: GTN patients who received EMA showed remissions as high as 74.4% - 96.6% of cases. The side effects of anemia in EMA were less toxic than EMACO, but it wasn’t the case in neutropenia. Two studies showed that 57,1% and 87% patients relapse within 2 years, while none in 5 years and 7 years follow-ups. Discussion: With EMACO use, it has been observed to result in increased morbidity and increased health care costs and when patients experience complications while staying overnight in the hospital, they are not monitored by a good specialist team. Patients treated with EMACO had more peripheral neuropathy as result of vincristine than EMA. The use of EMA certainly requires further evaluation. Conclusion: Patients with High-risk GTN who treated first-line with EMA or EMACO have an excellent prognosis. Both regiments are equally effective. There were differences in treatment scheduling, hospitalization requirements, and toxicity between regimens. Keywords: EMA, EMACO, gestational trophoblastic neoplasia Abstrak: Tujuan: Mengetahui efektivitas dan efikasi terbaik diantara EMA dan EMACO untuk pasien dengan NTG berisiko tinggi. Hasil: Pasien dengan NTG yang menerima EMA menunjukkan remisi setinggi 74.4%-96.6% dari kasus. Efek samping anemia dari EMA lebih tidak toksik dibandingkan EMACO, namun tidak dengan neutropenia. Dua studi menunjukkan bahwa 57.1% dan 87% pasien mengalami kekambuhan dalam 2 tahun, namun tidak ada dalam follow up 5 tahun dan 7 tahun. Diskusi: Dengan penggunaan EMACO, dapat diobservasi bahwa terdapat peningkatan morbiditas dan peningkatan biaya pelayanan kesehatan, dan ketika pasien mengalami komplikasi pada saat rawat inap di rumah sakit, mereka tidak dimonitor oleh tim spesialis yang baik. Pasien yang diterapi dengan EMACO memiliki efek samping neuropati perifer lebih tinggi yang disebabkan oleh vinkristin, dibandingkan EMA. Penggunaan EMA membutuhkan evaluasi lebih lanjut. Kesimpulan: Pasien dengan NTG berisiko tinggi yang diterapi dengan lini pertama EMA atau EMACO mempunya prognosis yang baik. Kedua regimen tersebut efektif. Ada perbedaan dalam penjadwalan terapi, kebutuhan rawat inap dan toksisitas antara regimen, Kata kunci: EMA, EMACO, neoplasia trofoblastik gestasional

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Characteristics of gestational thropoblast tumor in Dr. Soetomo Hospital, year 2015-2017

Cited by 2 publications

References 5 publications

Risk Factors That Correlate with Resistance to First-Line Chemotherapy on High-risk Gestational Trophoblastic Neoplasia

Risk Factors That Correlate with Resistance to First-Line Chemotherapy on High-risk Gestational Trophoblastic Neoplasia

EMA and EMACO Chemotherapy in High Risk Gestational Trophoblast Disease, which Better?

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