Gestational Trophoblastic Disease Diagnosis and Treatment: An Analysis of 56 Cases

Abstract

Objective To investigate the diagnosis and treatment of gestational trophoblastic disease (GTD). Methods A retrospective review was conducted on 56 patients with GTD who underwent treatment in Ruijin hospital from January 2007 to December 2012. Their information of diagnosis, treatments, follow-up and efficacy were collected and analyzed. Results Misdiagnosis rate was 41.1% (23/56) for the first time. Of 56 patients, 31 had direct curettage, 19 had curettage after trichosanthis (TCS) treatment, 3 had curettage after intervention treatment and 3 did not have curettage. Twenty patients with gestational trophoblastic neoplasia (GTN) took fluorouracil+vincristine+dactinomycin (VCR+KSM+5-FU) chemotherapy, but 2 of them changed to etoposide+methotrexate+actinomycetes streptozotocin-D+cyclophosphamide+vincristine (EMA-CO) chemotherapy due to drug resistance. Three patients with GTN took EMA-CO chemotherapy. Two patients with placental site trophoblastic tumor (PSTT) required surgeries, one took hysterectomy, another got mass and adnexectomy. Apart from 1 case who gave up treatment and was dead, all the other women went into remission from their diseases. Conclusion The diagnosis of trophoblastic disease rely on a comprehensive analysis. A reasonable choice of TCS or intervention can be effective and safe in treating GTD. Most patients with GTN could get complete remission by selecting the appropriate chemotherapy and surgery.