A clinical analysis of gestational trophoblastic disease:report of 155 cases

Objective To investigate the clinical features,treatment and outcome of the gestational trophoblastic disease (GTD). Methods The clinical date of 155 in-patients with GTD in our hospital between January,2008 and October,2013 were retrospectively analyzed and summarized.There were 99 cases of hydatidiform mole and 56 cases of trophoblastic tumor.35 patients were less than 25 year-old,49 patients were between 25 and 35 years of age,71 patients aged above 35.The cases with first,second,third or more pregnancies were 20,48,55 and 32,respectively. Results The age of patients were 17 to 52 year-old with an average of 31.7,among them,the patients aged above 35 year-old accounted for 45.8%,which was obviously higher than the proportion of the patients aged less than 25 year-old and between 25 and 35 years old.The incidence of GTD in patients with 2,3 and 4 and more pregnancies was significantly higher than that in patients with the first pregnancy (P<0.05).Among 99 cases of hydatidiform mole,51 patients underwent the dilatation and evacuation,32 cases underwent second curettage,8 patients underwent preventive chemotherapy combined with evacuation,and 8 patients underwent preventive chemotherapy combined hysterectomy.Among 56 cases of gestational trophoblastic neoplasia (GTN),9 patients received single-agent of Methotrexate,12 patients received 5-FU,9 cases received multiple-agent of EMA-Co,8 patients received BEP,2 patients received VP+DDP,and 16 patients received 5-FU+KSM.Chemotherapy courses were 3 to 11,averaged 5.47.The incidence of malignant transformation among hydatidiform mole was 12.1%.The cure rate of GTN was 85.7%. Conclusion The age and times of previous pregnancies are related to the occurrence of GTD.Women aged above 35 will be with a higher risk of GTD.The risk for GTD in women with a reproductive experience is higher than that in first-time moms.The hydatidiform moles tend to undergo malignant transformation.The early diagnosis,treatment and closely follow-up should be paid more attentions to the patients with GTD.