Determination of Clinical Process and Response Rate to Treatment in Patients with Gestational Trophoblastic Neoplasia (GTN) with Low and High Risk and Evaluation of Their First Pregnancy Outcome

Abstract

Background: The present study was conducted to determine the response to treatment in patients with GTN, the survival rate and to investigate the outcomes of first pregnancy after chemotherapy.

Materials and Methods:  The treatment protocol was based on the FIGO Staging of GTN and the Modified WHO Prognostic Scoring.

Results: Complete remission was achieved with MTX in 100% of the low-risk patients and with combination therapy in 91% of the high-risk cases. Out of 27 low-risk patients, 21 had no metastasis 6 had lung metastasis, 18 preserved their fertility and conceived in the first year following the chemotherapy. Out of 3 patients who had developed invasive moles, 1 got pregnant after chemotherapy. Four of the patients with choriocarcinoma conceived in the first year following the chemotherapy. In the patient with placental site trophoblastic tumors, there was no pregnancy due to hysterectomy.

Conclusion: GTN was found to be a chemosensitive condition, but more effective therapeutic protocols are therefore required. 

Keywords: Gestational trophoblastic neoplasia, Choriocarcinoma, High dose chemotherapy, Pregnancy