Gestational trophoblastic disease: A ten-year review

Abstract

Objectives: To determine the prevalence of different types of gestational trophoblastic disease, assess the factors involved in malignant conditions and to determine treatment outcomes. Methodology: A retrospective review was conducted to investigate all gestational trophoblastic disease cases from January 2002 to December 2011. Results: A total of 123 patients were diagnosed with gestational trophoblastic disease within ten years, including 98 cases of benign and 25 cases of malignant gestational trophoblastic disease. There were 53 (43.1%) patients with partial and 45 (36.6%) with complete hydatidiform mole. Malignant forms accounted for 25 (20.3%), persistent trophoblastic disease for 22 (17.9%) and choriocarcinoma for 3 (2.4%) cases. The risk of developing malignant gestational trophoblastic disease increased by 5% every year of life. Twenty-two women received methotrexate, including 19 stage I patients receiving single-agent methotrexate, with complete recovery achieved in 12 patients (63%). Seven stage I patients put on actinomycin D achieved complete recovery (37%). Three patients with choriocarcinoma received EMA-CO regimen as treatment. Conclusion: We estimated the prevalence of gestational trophoblastic disease at 2.8 in 1,000 pregnancies, which is higher compared to Europe/USA. The risk factors for malignant disease included age, high parity, and long interval since the last child birth. Standard treatment allows for favorable outcomes.