Human Chorionic Gonadotropin Regression Curves after Partial or Complete Molar Pregnancy in Flanders: Are They Different from Regression Curves from the Eighties?

Delattre, Sien; Han, Sileny N.; Moerman, Philippe; Billen, Jaak; Goffin, Frédéric; Scharpé, Kathleen; Vergote, Ignace

doi:10.1159/000458523

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…The trend toward earlier diagnosis for both complete mole and partial mole observed in our center is consistent with the global trends as the median gestational age at evacuation was 8.75±2.30 weeks for complete mole and 9.72±3.12 weeks for partial mole. Sun et al reported The median gestational age at evacuation was 9 weeks for complete mole and 12 weeks for partial mole 38 and reported in another study 29 that the median gestational age at diagnosis continued to decrease in two non-concurrent cohorts (1988-1993 versus 1994-2013) of patients from the New England Trophoblastic Disease Center; 9 weeks versus 12 weeks. Blood transfusion was required during evacuation of 69.7% of cases of complete moles and 48.0% of partial moles.…”

Section: Discussionmentioning

confidence: 97%

Incidence and outcome of gestational trophoblastic disease in lower Egypt

Zakaria¹,

Hemida²,

El-refaie³

et al. 2020

Afr H. Sci.

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Background. Gestational trophoblastic disease (GTD) defines a spectrum of proliferative disorders of trophoblastic epitheli- um of the placenta. Incidence, risk factors, and outcome may differ from one country to another. Objective. To describe incidence, patient characteristics, treatment modalities, and outcome of GTD at Mansoura University which is a referral center of Lower Egypt. Methods. An observational prospective study was conducted at the GTD Clinic of Mansoura University. The patients were recruited for 12 months from September 2015 to August 2016. The patients’ characteristics, management, and outcome were reported. Results. We reported 71 clinically diagnosed GTD cases, 62 of them were histologically confirmed, 58 molar (33 CM and 25 PM) in addition to 4 initially presented GTN cases. Mean age of the studied cases was 26.22 years ± 9.30SD. Mean pre-evacu- ation hCG was 136170 m.i.u/ml ±175880 SD. Most of the cases diagnosed accidentally after abnormal sonographic findings (53.2%). Rate of progression of CM and PM to GTN was 24.2% and 8%, respectively. Conclusion. The incidence of molar pregnancy and GTN in our locality was estimated to be 13.1 and 3.2 per 1000 live births respectively. We found no significance between CM and PM regarding hCG level, time to hCG normalization, and progression rate to GTN. Keywords. Molar pregnancy; incidence; outcome.

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Section: Discussionmentioning

confidence: 97%

Incidence and outcome of gestational trophoblastic disease in lower Egypt

Zakaria¹,

Hemida²,

El-refaie³

et al. 2020

Afr H. Sci.

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“…Lybol et al [20] however reported normalization of hCG regression normograms after 3 rd and 6 th courses for single and multiple agents for patients with high risk GTN in Netherlands. Delattre et al [21] found mean time to normalization of 14-15 weeks after evacuation for complete or partial molar pregnancy in his study in Flanders. Two patients had relapse after cure and 1 died while awaiting recommencement of chemotherapy for relapse after single agent chemotherapy with methotrexate.…”

Section: Discussionmentioning

confidence: 83%

Outcome of chemotherapy for gestational trophoblastic disease in Aminu Kano teaching hospital: A 5-year review

Avidime¹,

Zainab²,

Hadiza³

2020

Int. J. Clin. Obstet. Gynaecol.

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Background: Gestational trophoblastic diseases are the first and only disseminated solid tumours that have proved to be highly curable by chemotherapy. Chemotherapy can be used for both the premalignant and malignant forms with cure rates of upto 100% in hydatidiform moles and low risk GTD while in high risk GTDs, cure rates of 80 -90% have been achieved. Objectives: To determine the outcome of chemotherapy for gestational trophoblastic disease in Aminu Kano Teaching Hospital, Kano. Study design: Retrospective study of the outcome of chemotherapy for gestational trophoblastic disease in Aminu Kano Teaching Hospital between 1 st January 2013 and 31 st December 2017. Results: The prevalence of GTD was 6.2/1000 (1 in 160) deliveries and it accounted for 2.8% of gynaecological admissions over the study period. The indications for chemotherapy for GTD in Aminu Kano Teaching Hospital were persistent GTD, choriocarcinoma and invasive mole. Complete remission was achieved in 83.4% of cases and this falls within the 80-100% reported by the American cancer society while relapse and refractory disease were observed in 8.3% each. Overall, the default rate was high (68.5%) for all the treatment modalities and a case fatality rate of 2.9% was observed. Conclusion:The cure rate of 83.4% found in this study is within the 80-90% cure rates reported for highrisk gestational trophoblastic disease. However, the default rate was high (68.5%) for the various treatment modalities and needs to be improved upon.

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“…The reference centre advises on treatment or follow-up. hCG normalisation curves of this dataset were published previously [13].…”

Section: Belgian Register For Trophoblastic Diseasesmentioning

confidence: 99%

Curative effect of second curettage for treatment of gestational trophoblastic disease - Results of the Belgian registry for gestational trophoblastic disease

Vandewal

Delbecque

Rompuy

et al. 2021

European Journal of Obstetrics & Gynecology and Reproductiv

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We assessed the curative effect of a second curettage in patients with persistent hCG serum levels after first curettage for a gestational trophoblastic disease (GTD). Study Design: This prospective observational study used the data of the Belgian register for GTD between July 2012 and January 2017. We analysed the data of patients who underwent a second curettage. We included 313 patients in the database. Primary endpoints were need for second curettage and chemotherapy. Results: Thirty-seven patients of the study population (12 %) underwent a second curettage. 20 had persistent human chorionic gonadotropin hormone (hCG) elevation before second curettage. Of them, 9 patients (45 %) needed no further treatment afterwards. Eleven patients (55 %) needed further chemotherapy. Nine (82 %) were cured with single-agent chemotherapy and 2 patients (18 %) needed multi-agent chemotherapy. Of the 37 patients, patients with hCG levels below 5000 IU/L undergoing a second curettage were cured without chemotherapy in 65 % versus 45 % of patients with hCG level more than 5000 IU/L. Of the ten patients with a hCG level below 1000 IU/L, eight were cured without chemotherapy. Conclusions: Patients with post-mole gestational trophoblastic neoplasia can benefit from a second curettage to avoid chemotherapy, especially when the hCG level is lower than 5000 IU/L.

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Human Chorionic Gonadotropin Regression Curves after Partial or Complete Molar Pregnancy in Flanders: Are They Different from Regression Curves from the Eighties?

Cited by 3 publications

References 18 publications

Incidence and outcome of gestational trophoblastic disease in lower Egypt

Incidence and outcome of gestational trophoblastic disease in lower Egypt

Outcome of chemotherapy for gestational trophoblastic disease in Aminu Kano teaching hospital: A 5-year review

Curative effect of second curettage for treatment of gestational trophoblastic disease - Results of the Belgian registry for gestational trophoblastic disease

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