Prognosis of Patients with Gestational Trophoblastic Neoplasia and Obstetric Outcomes of Those Conceiving After Chemotherapy.

Angiolo Gadducci, Stefania Cosio, Antonio Fanucchi, Roberta Tana, Simona Manacorda, Sabina Pistolesi, Francesca Letizia Strigini

Journal: Anticancer research 2017;36(7):3477-82

PMID: 27354611

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Abstract

AIM

To assess prognosis of gestational trophoblastic neoplasia (GTN) and obstetric outcome after chemotherapy.

PATIENTS AND METHODS

Sixty-six patients had diagnosis of hydatiform mole on curettage and 18 developed GTN. Two patients were referred with pathological diagnosis of GTN. Chemotherapy was tailored according to International Federation of Gynecology and Obstetrics risk scoring system.

RESULTS

All patients with GTN but one, were recovered by chemotherapy and had no evidence of disease after a median follow-up of 80 months. Only the patient with epithelioid trophoblastic tumor died of disease. Seven out of the eight women who tried to conceive after chemotherapy became pregnant. Ten conceptions occurred, resulting in no molar pregnancy, three miscarriages and seven term-live healthy births (70.0%). All seven babies showed normal development and growth after a median follow-up of 38 months.

CONCLUSION

The prognosis of women with GTN is very good, and obstetric outcomes of those who conceive after chemotherapy are similar to those of the general population.

Address: Division of Gynecology and Obstetrics, Department of Clinical and Experimental Medicine, Division of Pathology, University of Pisa, Pisa, Italy [email protected].; Division of Gynecology and Obstetrics, Department of Clinical and Experimental Medicine, Division of Pathology, University of Pisa, Pisa, Italy.; Translational Research and New Technologies in Medicine and Surgery, Division of Pathology, University of Pisa, Pisa, Italy.

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MeSH Terms: Adolescent, Adult, Antineoplastic Combined Chemotherapy Protocols, Chorionic Gonadotropin, beta Subunit, Human, Dactinomycin, Etoposide, Female, Fertility Preservation, Gestational Trophoblastic Disease, Humans, Leucovorin, Methotrexate, Middle Aged, Pregnancy, Prognosis, Term Birth, Treatment Outcome, Uterine Neoplasms, Young Adult