Clinical Characteristics of Gestational Trophoblastic Neoplasia: A 15-Year Hospital-Based Study

Objective To analyze the clinical profile of invasive mole (IM) and choriocarcinoma (CCA) in the past 15 years in Western China. Materials and Methods A retrospective study was performed on 221 patients with IM and 70 patients with CCA treated in the First Affiliated Hospital of Xi’an Jiaotong University from 1994 to 2009. Patients were assigned into 3 groups by 5 years, and the clinical characteristics were compared among these groups. Results The incidence was not significantly changed in the past 15 years, whereas the mean age of gestational trophoblastic neoplasia (GTN) was increased significantly, especially for the patients 40 years or older. The symptoms of the patients with GTN did not show significant variation, but the number of patients with CCA without clinical symptoms was increased significantly. The mean values of beta human chorionic gonadotropin in the patients with IM and those with CCA were 459.43 and 661.70 mIu/L, respectively, and the size of uterine lesion was concentrated at 4 cm or less in both the patients with IM and those with CCA, without significant differences. Conclusions In the past 15 years, the incidence of GTN was still higher than in other countries from 1994 to 2009, and the mean age of patients with GTN was increased significantly, especially for the patients older than 40 years. Furthermore, patients with no clinical manifestations increased significantly, which should be paid more attention in the future works. Serum level of beta human chorionic gonadotropin and pelvic ultrasonography are still 2 important indexes for diagnosing and monitoring condition of GTN.

[1]  M. Seckl,et al.  Brain metastases in gestational trophoblast neoplasia: an update on incidence, management and outcome. , 2015, Gynecologic oncology.

[2]  T. Elhassan,et al.  Gestational trophoblastic neoplasia: treatment outcomes from a single institutional experience , 2015, Clinical and Translational Oncology.

[3]  Jae-Weon Kim,et al.  Trophoblastic Disease Review for Diagnosis and Management: A Joint Report From the International Society for the Study of Trophoblastic Disease, European Organisation for the Treatment of Trophoblastic Disease, and the Gynecologic Cancer InterGroup , 2014, International Journal of Gynecologic Cancer.

[4]  S. Ramani,et al.  Gestational Trophoblastic Disease: A Multimodality Imaging Approach with Impact on Diagnosis and Management , 2014, Radiology research and practice.

[5]  P. Akbari,et al.  Frequency of Molar Pregnancies in Health Care Centers of Tehran, Iran , 2014, Journal of reproduction & infertility.

[6]  G. Tulunay,et al.  Multicenter analysis of gestational trophoblastic neoplasia in Turkey. , 2014, Asian Pacific journal of cancer prevention : APJCP.

[7]  R. Coleman,et al.  The outcome of patients with low risk gestational trophoblastic neoplasia treated with single agent intramuscular methotrexate and oral folinic acid. , 2013, European journal of cancer.

[8]  N. Sebire,et al.  Treatment outcomes for 618 women with gestational trophoblastic tumours following a molar pregnancy at the Charing Cross Hospital, 2000–2009 , 2012, British Journal of Cancer.

[9]  R. Berkowitz,et al.  Current Chemotherapeutic Management of Patients with Gestational Trophoblastic Neoplasia , 2011, Chemotherapy research and practice.

[10]  M. Bergström,et al.  Reporting and incidence trends of hydatidiform mole in Sweden 1973–2004 , 2011, Acta oncologica.

[11]  J. Tidy,et al.  Influence of age as a factor in the outcome of gestational trophoblastic neoplasia. , 2008, Journal of reproductive medicine.

[12]  R. An,et al.  Combination chemotherapy with 5-fluorouracil, methotrexate and etoposide for patients with high-risk gestational trophoblastic tumors: a report based on our 11-year clinical experiences. , 2006, Gynecologic oncology.

[13]  C. Muller,et al.  Changing trends in gestational trophoblastic disease. , 2006, The Journal of reproductive medicine.

[14]  Y. Qiao,et al.  [Survey of gestational trophoblastic disease incidence among 3.6 million pregnancies in China]. , 2005, Zhonghua fu chan ke za zhi.

[15]  M. Harma,et al.  Gestational trophoblastic disease in Sanliurfa, southeast Anatolia, Turkey. , 2005, European journal of gynaecological oncology.

[16]  C. la Vecchia,et al.  Oral contraceptives and risk of gestational trophoblastic disease. , 2002, Contraception.

[17]  R. Mclellan,et al.  Gestational trophoblastic disease. , 2001, Obstetrics and gynecology clinics of North America.

[18]  H. Ngan,et al.  FIGO staging classifications and clinical practice guidelines in the management of gynecologic cancers. FIGO Committee on Gynecologic Oncology. , 2000, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[19]  M. Bracken,et al.  Epidemiology of hydatidiform mole and choriocarcinoma. , 1984, Epidemiologic reviews.