Clinical characteristics, treatment outcomes, and factors associated with postmolar gestational trophoblastic neoplasia in patients with hydatidiform mole: a single-center retrospective cohort study

Ayşe Hazırbulan; Rukiye Akman; Taşkın Erkinüresin; Tolga Çiftpınar; Ozgur Akbayir; Merve Aldıkaçtıoğlu Talmaç

Clinical characteristics, treatment outcomes, and factors associated with postmolar gestational trophoblastic neoplasia in patients with hydatidiform mole: a single-center retrospective cohort study

Abstract

Aims: This study evaluated the clinical, laboratory, ultrasonographic, histopathological, treatment, and follow-up characteristics of patients with molar pregnancy and assessed the clinical relevance of baseline factors associated with the development of postmolar gestational trophoblastic neoplasia (GTN) in a contemporary single-center cohort. Methods: This retrospective cohort included 259 patients with hydatidiform mole. Demographic, clinical, laboratory, ultrasonographic, histopathological, treatment, and follow-up data were reviewed. Patients with unknown GTN status were excluded from comparative analyses. Group comparisons used the Mann-Whitney U, Chi-square, or Fisher’s exact test. Multivariable logistic regression was used to evaluate factors independently associated with postmolar GTN development. Firth-penalized logistic regression and a sensitivity analysis restricted to patients with adequate follow-up were additionally performed to assess the robustness of the findings. Results: Among 259 patients, partial hydatidiform mole was diagnosed in 163 patients (62.9%), complete hydatidiform mole in 80 (30.9%), and hydatidiform mole of unspecified subtype in 16 (6.2%). Postmolar GTN developed in 39 patients (15.1%), while GTN status was unknown in 12 (4.6%). Chemotherapy was administered to 33 patients (12.7%); all received a methotrexate folinic acid regimen. Overall, normalization of beta-human chorionic gonadotropin (β-hCG) was achieved in 247 patients (95.4%). In multivariable analysis, initial β-hCG level per 100.000 mIU/ml increase (adjusted OR, 1.34; 95% CI, 1.15-1.56; p<0.001) and the presence of a theca lutein cyst (adjusted OR, 9.05; 95% CI, 2.33-35.07; p=0.001) were independently associated with postmolar GTN development. These associations remained consistent in Firth-penalized logistic regression and in the sensitivity analysis restricted to patients with adequate follow-up. Conclusion: Established markers of trophoblastic burden, particularly higher initial β-hCG levels and the presence of theca lutein cysts, were independently associated with postmolar GTN in this contemporary cohort. The consistency of these associations across complementary analyses supports the clinical relevance of early biochemical and ultrasonographic assessment, while serial post-evacuation β-hCG surveillance remains the cornerstone of follow-up.

Keywords

Supporting Institution

No financial support was received from any public, private, or non-profit organization for this research.

Project Number

2026.03.125

Ethical Statement

This retrospective study was approved by the Scientific Research Ethics Committee of University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Türkiye (decision no: 125; approval date: 25 March 2026; approval/file no: 2026.03.125; reference no: KAEK/2026.03.125). The requirement for written informed consent was waived because of the retrospective design and the use of anonymized patient-level data.

Thanks

The authors thank the clinical team of the Department of Gynecologic Oncology Surgery at Kanuni Sultan Süleyman Training and Research Hospital for their support in the care and follow-up of patients with molar pregnancy.

References

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Details

Primary Language

English

Subjects

Obstetrics and Gynaecology

Journal Section

Research Article

Authors

Ayşe Hazırbulan ^*
0000-0002-0206-1697
Türkiye

Rukiye Akman
0009-0001-9662-1252
Türkiye

Taşkın Erkinüresin
0000-0003-1725-6590
Türkiye

Tolga Çiftpınar
0000-0001-7406-0629
Türkiye

Ozgur Akbayir
0000-0002-2699-4969
Türkiye

Merve Aldıkaçtıoğlu Talmaç
0000-0001-7219-1772
Türkiye

Publication Date

October 25, 2026

Submission Date

June 16, 2026

Acceptance Date

September 18, 2026

Published in Issue

Year 2026 Volume: 8 Number: 6

IZ

https://izlik.org/JA44GR75LS

Cite

RIS / Bibtex

APA

Hazırbulan, A., Akman, R., Erkinüresin, T., Çiftpınar, T., Akbayir, O., & Aldıkaçtıoğlu Talmaç, M. (2026). Clinical characteristics, treatment outcomes, and factors associated with postmolar gestational trophoblastic neoplasia in patients with hydatidiform mole: a single-center retrospective cohort study. Anatolian Current Medical Journal, 8(6), 1298-1307. https://izlik.org/JA44GR75LS

AMA

1.Hazırbulan A, Akman R, Erkinüresin T, Çiftpınar T, Akbayir O, Aldıkaçtıoğlu Talmaç M. Clinical characteristics, treatment outcomes, and factors associated with postmolar gestational trophoblastic neoplasia in patients with hydatidiform mole: a single-center retrospective cohort study. Anatolian Curr Med J / ACMJ / acmj. 2026;8(6):1298-1307. https://izlik.org/JA44GR75LS

Chicago

Hazırbulan, Ayşe, Rukiye Akman, Taşkın Erkinüresin, Tolga Çiftpınar, Ozgur Akbayir, and Merve Aldıkaçtıoğlu Talmaç. 2026. “Clinical Characteristics, Treatment Outcomes, and Factors Associated With Postmolar Gestational Trophoblastic Neoplasia in Patients With Hydatidiform Mole: A Single-Center Retrospective Cohort Study”. Anatolian Current Medical Journal 8 (6): 1298-1307. https://izlik.org/JA44GR75LS.

EndNote

Hazırbulan A, Akman R, Erkinüresin T, Çiftpınar T, Akbayir O, Aldıkaçtıoğlu Talmaç M (October 1, 2026) Clinical characteristics, treatment outcomes, and factors associated with postmolar gestational trophoblastic neoplasia in patients with hydatidiform mole: a single-center retrospective cohort study. Anatolian Current Medical Journal 8 6 1298–1307.

IEEE

[1]A. Hazırbulan, R. Akman, T. Erkinüresin, T. Çiftpınar, O. Akbayir, and M. Aldıkaçtıoğlu Talmaç, “Clinical characteristics, treatment outcomes, and factors associated with postmolar gestational trophoblastic neoplasia in patients with hydatidiform mole: a single-center retrospective cohort study”, Anatolian Curr Med J / ACMJ / acmj, vol. 8, no. 6, pp. 1298–1307, Oct. 2026, [Online]. Available: https://izlik.org/JA44GR75LS

ISNAD

Hazırbulan, Ayşe - Akman, Rukiye - Erkinüresin, Taşkın - Çiftpınar, Tolga - Akbayir, Ozgur - Aldıkaçtıoğlu Talmaç, Merve. “Clinical Characteristics, Treatment Outcomes, and Factors Associated With Postmolar Gestational Trophoblastic Neoplasia in Patients With Hydatidiform Mole: A Single-Center Retrospective Cohort Study”. Anatolian Current Medical Journal 8/6 (October 1, 2026): 1298-1307. https://izlik.org/JA44GR75LS.

JAMA

1.Hazırbulan A, Akman R, Erkinüresin T, Çiftpınar T, Akbayir O, Aldıkaçtıoğlu Talmaç M. Clinical characteristics, treatment outcomes, and factors associated with postmolar gestational trophoblastic neoplasia in patients with hydatidiform mole: a single-center retrospective cohort study. Anatolian Curr Med J / ACMJ / acmj. 2026;8:1298–1307.

MLA

Hazırbulan, Ayşe, et al. “Clinical Characteristics, Treatment Outcomes, and Factors Associated With Postmolar Gestational Trophoblastic Neoplasia in Patients With Hydatidiform Mole: A Single-Center Retrospective Cohort Study”. Anatolian Current Medical Journal, vol. 8, no. 6, Oct. 2026, pp. 1298-07, https://izlik.org/JA44GR75LS.

Vancouver

1.Ayşe Hazırbulan, Rukiye Akman, Taşkın Erkinüresin, Tolga Çiftpınar, Ozgur Akbayir, Merve Aldıkaçtıoğlu Talmaç. Clinical characteristics, treatment outcomes, and factors associated with postmolar gestational trophoblastic neoplasia in patients with hydatidiform mole: a single-center retrospective cohort study. Anatolian Curr Med J / ACMJ / acmj [Internet]. 2026 Oct. 1;8(6):1298-307. Available from: https://izlik.org/JA44GR75LS