Gestational Trophoblastic Neoplasia—Fertility Outcomes and Survival
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To investigate the survival and fertility outcomes of the patients treated for gestational trophoblastic neoplasia (GTN).
The clinical records of all the GTN patients registered and treated between January 1, 2008, and December 31, 2013, at a regional cancer center (RCC) in Tamil Nadu, India, were reviewed. About 35 patients with GTN were identified; 29 patients were included in the study. Methotrexate and the EMACO (Etoposide, Methotrexate, Adriamycin, Cyclophosphamide, and Vincristine) regimen were administered based on the risk score evaluation, beta human chorionic gonadotropin (HCG) levels were tested during follow-ups, and annual ultrasonography and chest radiography were performed.
Approximately 15 (51.7%) and 14 (48.3%) patients had low- and high-risk scores, respectively. Five patients (17.2%) underwent hysterectomy, and 21 (72.4%) underwent chemotherapy. Twenty-eight patients (96.6%) survived, and only one (3.4%) died after the treatment because of lung metastasis and pulmonary infections. The overall survival rate in the primary setting was 96.6%. With regard to child-bearing outcomes, 14 patients (48.3%) did not desire a child. Of 15 women who wished to conceive after the treatment, 9 could not conceive, 3 had abortions, and 3 had a normal delivery.
The diagnosis was made using radiological imaging and beta HCG levels for low- and high-risk patients, and the follow-up management was effective in yielding a fertility outcome where patients were able to resume normal reproductive functions. GTN is a highly curable malignancy regardless of the stage and its metastatic nature.
KeywordsGTN Survival outcome Fertility outcome Beta HCG EMACO Methotrexate
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
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