Clinicopathological Features and Treatment Outcomes of Gestational Trophoblastic Disease: A Retrospective Study From A Tertiary Care Center in Türkiye

Year 2025, Volume: 4 Issue: 2, 40 - 46, 30.06.2025

Uğur Özberk Selin Aktürk Esen , İsmet Seven Öznur Bal , Efnan Algın , Burak Bilgin , Dogan Uncu

https://doi.org/10.5505/achmedj.2025.25633

Abstract

Introductıon: This research aimed to evaluate the clinical features, treatment modalities, and outcomes in patients with gestational trophoblastic disease (GTD).

Methods: A retrospective study was performed on 27 patients diagnosed with GTD. Data were collected from hospital records, including demographic details, clinical presentations, FIGO staging, and chemotherapy regimens. Treatment outcomes were assessed based on complete remission (CR) rates, treatment duration, and resistance to therapy.

Results: The median age of the patients was 27 (18–53) years, and the majority were FIGO stage I (77.8%). Chemotherapy regimens included weekly methotrexate in 11 patients (40.7%), five-day methotrexate (14.8%) in four patients, and etoposide,methotrexate and dactinomycin (EMA) / cyclophosphamide and vincristine (CO) in six patients (22.2%), while six (22.2%) patients achieved spontaneous remission without chemotherapy. CR rates were high across all regimens, with 81.8% for weekly methotrexate, 75% for five-day methotrexate, and 83.3% for EMA-CO. Resistant disease was observed in four (14.8%) patients. The median duration to CR varied by regimen, ranging from 5 to 10 weeks.

Conclusion: GTD is a highly chemotherapy-sensitive disease with excellent CR rates in both low- and high-risk patients. Accurate risk stratification and individualized treatment remain key to optimizing outcomes. Further studies are needed to address challenges in resistant cases and explore emerging therapies.

Keywords

Gestational trophoblastic neoplasia , Hydatidiform mole , Methotrexate , EMA-CO protocol.

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