Hydatidiform mole in the elderly: Hysterectomy or evacuation?

Bahar, A.M.; El-ashnehi, M. S.; Senthilselvan, Ambikaipakan

doi:10.1016/0020-7292(89)90260-9

Cited by 21 publications

(14 citation statements)

References 10 publications

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“…It has been shown to be effective in reducing the risk of developing GTN but exposes more than 80% of patients to unnecessary toxicity and may induce resistance; thus, it is no longer recommended. 1 On the other hand, Bahar et al 13 have compared the outcome of 24 patients older than 35 years treated by D&E and serum A-hCG monitoring and of 10 patients treated by primary hysterectomy. They found no significant difference in the development of postmolar GTN.…”

Section: Discussionmentioning

confidence: 99%

Role of Surgery in the Management of Hydatidiform Mole in Elderly Patients

Giorgione

Bergamini

Cioffi

et al. 2017

International Journal of Gynecological Cancer

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Section: Discussionmentioning

confidence: 99%

Role of Surgery in the Management of Hydatidiform Mole in Elderly Patients

Giorgione

Bergamini

Cioffi

et al. 2017

International Journal of Gynecological Cancer

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“…In our study, vacuum curettage was performed in all patients, while no hysterectomies were done. In the literature, hysterectomy is usually used to treat old grand multiparity patients because malignant degeneration increases with age and the risk decreases from 20% to 3-10% with hysterectomy (18,19). Chemotherapy is given if the β-hCG level plateaus or increases or stays high for more than 6 months, choriocarcinoma is diagnosed histologically, or metastatic disease is present (20).…”

Section: Discussionmentioning

confidence: 99%

Incidence of gestational trophoblastic disease in Tokat province, Turkey

Çakmak¹,

Toprak²,

Nacar³

et al. 2014

J Turkish German Gynecol Assoc

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59,754 births in Tokat province. During this period, 73 cases were diagnosed as GTD histopathologically. The calculated GTD incidence was 1.22 per 1000 births. The mean age of the diagnosed patients was 28.6±7.3 (range 17-51) years. Many patients were aged 20-29 years (Figure 1). The mean numbers of pregnancies, births, and abortions were 3.5±2.9 (range 1-15), 1.3±1.4 (range 0-5), and 1.1±2.3 (range 0-13),Objective: This study investigated the incidence of gestational trophoblastic disease (GTD) in Tokat province, Turkey. Material and Methods:The medical records of patients who had been diagnosed and treated at one university hospital, six government hospitals, and one specialist hospital in Tokat province between January 2005 and December 2012 were evaluated retrospectively.Results: During the study period, there were 59,754 births and GTD was diagnosed in 73 cases. The calculated GTD incidence was 1.22/1000. The mean age of the patients diagnosed with GTD was 28.6±7.3 (range 17-51) years. In GTD, complete moles occurred in 26%, partial moles in 74%, and no invasive moles, choriocarcinomas, or placental site trophoblastic tumours were found. Only two patients received chemotherapy (methotrexate). There was no mortality associated with the disease during follow-up. Conclusion:The incidence of GTD in Tokat province was 1.2 per 1000 births. Early diagnosis, treatment, and follow-up play a critical role in preventing the morbidity and mortality associated with disease. The incidence of GTD, which has a high recovery rate with adequate treatment and follow-up, can be determined from regional and community-based research. (J Turk Ger Gynecol Assoc 2014; 15: 22-4) Key words: Gestational trophoblastic disease, molar pregnancy, incidence Received: 11 October, 2013 Accepted: 09 November, 2013 Incidence of gestational trophoblastic disease in Tokat province, Turkey

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“…Because malignant sequelae are more prone to occur in older age groups-37.5% of patients aged Ն50 years versus 27.5% of patients aged 40 -49 years versus 13.9% of patients aged Յ15 years-after molar evacuation [14], hysterectomy plays a crucial role in the management of these patients and offers a lower risk for malignant sequelae than with suction D&E [15]. Hysterectomy decreases the overall risk for postmolar GTN to approximately 3.5% from the anticipated 20% following suction D&E [8].…”

Section: Hysterectomymentioning

confidence: 99%

“…All patients should be chemically monitored after hysterectomy because it does not completely eliminate the potential for postmolar GTN [8,15].…”

Section: Hysterectomymentioning

confidence: 99%

The Role of Surgery and Radiation Therapy in the Management of Gestational Trophoblastic Disease

Hanna

Soper

2010

The Oncologist

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After completing this course, the reader will be able to:1. Describe the indications for surgical intervention in the management of patients with hydatidiform moles and malignant GTN in order to choose patients most likely to benefit from these interventions.2. Discuss the use of radiation in the management of patients with malignant GTN and consider its use as an adjunct to chemotherapy or surgery.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTThe primary management of hydatidiform moles remains surgical evacuation followed by human chorionic gonadotropin level monitoring. Although suction dilatation and evacuation is the most frequent technique for molar evacuation, hysterectomy is a viable option in older patients who do not wish to preserve fertility. Despite advances in chemotherapy regimens for treating malignant gestational trophoblastic neoplasia, hysterectomy and other extirpative procedures continue to play a role in the management of patients with both lowrisk and high-risk gestational trophoblastic neoplasia. Primary hysterectomy can reduce the amount of chemotherapy required to treat low-risk disease, whereas surgical resections, including hysterectomy, pulmonary resections, and other extirpative procedures, can be invaluable for treating highly selected patients with persistent, drug-resistant disease. Radiation therapy is also often incorporated into the multimodality therapy of patients with high-risk metastatic disease. This review discusses the indications for and the role of surgical interventions during the management of women with hydatidiform moles and malignant gestational trophoblastic neoplasia and reviews the use of radiation therapy in the treatment of women with malignant gestational trophoblastic neoplasia. The Oncologist 2010;15: 593-600Correspondence: John T. Soper, M.D., CB 7852, B110 Physicians Office Building,

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Hydatidiform mole in the elderly: Hysterectomy or evacuation?

Cited by 21 publications

References 10 publications

Role of Surgery in the Management of Hydatidiform Mole in Elderly Patients

Role of Surgery in the Management of Hydatidiform Mole in Elderly Patients

Incidence of gestational trophoblastic disease in Tokat province, Turkey

The Role of Surgery and Radiation Therapy in the Management of Gestational Trophoblastic Disease

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