BİR ÜNİVERSİTE HASTANESİNDE GESTASYONEL TROFOBLASTİK HASTALIK OLGULARININ DEĞERLENDİRİLMESİ

Abstract

Amaç: Gestasyonel trofoblastik hastalık (GTH) tanısı almış olguların klinikopatolojik özelliklerinin ve tedavilerinin değerlendirilmesi. Yöntemler: 2003- 2013 yılları arasında kliniğimize GTH tanısı ile yatırılmış olan ve bilgilerine ulaşılan 34 hasta bu çalışmaya alınmıştır. Hastaların demografik, kliniko-patolojik özellikleri ile uygulanan tedavi yöntemleri ve izlem sonuçları retrospektif olarak değerlendirilmiştir. Bulgular: Çalışmamızda 27 adet hidatiform mol (HM) (15 komplet, 12 parsiyel), 7 adet non-metastatik gestasyonel trofoblastik neoplazi (NM-GTN) olgusu değerlendirilmiştir. Olguların yaş ortalaması 31,3± 9,2 yıl, ortalama gebelik sayısı 2,7± 1,5, ortalama doğum sayısı 1,13± 1,03, düşük ve geçirilmiş mol gebelik oranları sırasıyla ortalama 0,3± 0,5 ve 0,1± 0,4 şeklinde idi. HM tanısı almış olguların 3 tanesinde (%8,8) tedavi sonrası mol gebelik tekrarlamış, bunlardan birinde histerektomi, diğer ikisinde tekrar revüzyone küretaj (R/C) ile remisyon sağlanmıştır. NM-GTN tanılı hastaların tümünde tek ajan kemoterapi ile remisyon sağlanmıştır. Sonuç: Gestasyonel trofoblastik hastalık, erken tanı, uygun tedavi ve izlem yapıldığında remisyon oranları yüksektir. Ancak tedaviye bağlı ciddi komplikasyonlar ile karşılaşılabilir.

Keywords

• Gestasyonel trofoblastik hastalık, mol hidatiform, gestasyonel trofoblastik neoplazi

OUTCOMES OF PATIENTS WITH GESTATIONAL TROPHOBLASTIC DISEASE IN AN UNIVERSITY HOSPITAL

Abstract

Aim: To investigate the clinicopathologic features and treatment procedures of the patients who diagnosed as Gestational Trophoblastic Disease (GTD). Methods: Thirty-four patients who pre-diagnosed as GTD between the years 2003- 2013 included to this investigation. Descriptive and clinicopathologic features, treatment and follow-up results of the patients investigated retrospectively. Results: Totally 27 hydatiform mole (HM) (15 of them complete and 12 of them partial) and 7 non-metastatic gestational trophoblastic neoplasia (NM-GTN) case was found in 10 years period of time. The mean age of the patients was 331,37± 9,27 (16-52), the pregnancy rate was 2,7± 1,5 (0-7), parity rate was 1,13± 1,03 (0-4), the abortus and history of molar pregnancy rates were 0,35± 0,58 (0-2) ve 0,15± 0,44 (0-2), respectively. Three recurrences (8,8%) was seen in HM cases and two of them needed repeat curettage (R/C) and the other one needed hystetectomy and all the three cases survived. Single agent chemotheraphy was been successful in all the GTN cases. Conclusion: GTD is a curable condition with early diagnosis, adequate management and follow-up. Complications due to treatment should be kept in mind.

Keywords

• hydatidiform mole, gestational trophoblastic disease, gestational trophoblastic neoplasia.

References

1. 1. Schorge JO, Schaffer JI, Halvorson LM, Hoffman BL, Bradshaw KD, Cunningham FG. Williams Gynecology. McGraw Hill Companies, 2008.
2. 2. Lurain JR. Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole. Am J Obstet Gynecol. 2010;203(6):531-9.
3. 3. Altieri A, Franceschi S, Ferlay J, Smith J, La Vecchia C. “Epidemiology and aetiology of gestational trophoblastic diseases”. Lancet Oncol. 2003;4:670-8.
4. 4. Ozalp SS, Yalçin OT, Tanir HM. Hydatidiform mole in Turkey from 1932 to 2000. Int J Gynaecol Obstet. 2001;73:257- 8.
5. 5. Ozalp SS, Oge T. Gestational trophoblastic diseases in Turkey. J Reprod Med. 2013;58:67-71.
6. 6. Ozalp SS, Yalcin OT, Tanir HM. Hydatidiform mole at extreme ages of reproductive life in a developing country from 1932 to 2000. Eur J Gynaecol Oncol. 2002;23:361-2.
7. 7. Gestational Trophoblastic Tumors Treatment - National Cancer Institute”. Retrieved in 21.3.2010.
8. 8. Tidy JA, Gillespie AM, Bright N, Radstone CR, Coleman RE, Hancock BW. Gestational trophoblastic disease: a study of mode of evacuation and subsequent need for treatment with chemotherapy. Gynecol Oncol. 2000;78:309-12.

9. 9. Soto-Wright V, Bernstein M, Goldstein DP, Berkowitz RS. The changing clinical presentation of complete molar pregnancy. Obstet Gynecol. 1995;86:775-9.
10. 10. Cheung AN, Khoo US, Lai CY, et al. Metastatic trophoblastic disease after an initial diagnosis of partial hydatidiform mole: genotyping and chromosome in situ hybridization analysis. Cancer. 2004;100:1411-7.
11. 11. Igwegbe A, Eleje G. Hydatidiform mole: A Review of Management Outcomes in a Tertiary Hospital in South-East Nigeria. Ann Med Health Sci Res. 2013;3:210-4.
12. 12. Gulia S, Bajpai J, Gupta S, et al. Outcome of gestational trophoblastic neoplasia: experience from a tertiary cancer centre in India. Clin Oncol (R Coll Radiol). 2014;26:39-44.