Normal view MARC view ISBD view

Clinical, socioeconomic characteristics, treatment and reproductive outcomes of patients with gestational trophoblastic neoplasia at a tertiary care hospital in India

In Gynecologic Oncology
By: Ghosh J.
Contributor(s): Agarwal P | Kapoor A | Philip DSJ | Choudhary V | Bajpai J | Gulia S | Rath A | Maheshwari A | Chopra S | Mahantshetty U | Sable N | Popat P | Shetty NS | Thakur MH | Kulkarni SS | Menon S | Rekhi B | Gupta S.
Material type: materialTypeLabelArticlePublisher: 2020Description: .Subject(s): Clinical | Socioeconomic characteristics | Patients | Hospital in India | Gestational In: Gynecologic OncologySummary: Objective: Gestational trophoblastic neoplasia (GTN) is a rare disease. The primary objective of the study was to evaluate diseasefree survival (DFS), and the secondary objective was to analyze clinical and socioeconomic characteristics, chemotherapy response, reproductive outcome, and overall survival (OS). Method: This was a single-institution retrospective study in a tertiary care cancer center in India. All patients diagnosed with GTN from January 2009 to December 2014 at our hospital were evaluated. Data were retrieved from case files and electronic medical records. The data were analyzed using SPSS v23.0. DFS and OS were estimated by the Kaplan–Meier method. Results: A total of 153 patients were diagnosed with GTN during this period, of which 136 (89%) were from a socioeconomically challenged background. The median age of the patients was 28 years (range 18–54 years). The median β hCG was 53726 IU/ml (range 18–10440587). These data were analyzed for 143 patients after excluding 10 patients lost to follow-up immediately after diagnosis. The median duration of follow-up was 63months. Sixty-two (43%) patients were low risk and 79 (55%) were high risk, while data were not available for 2 patients. Among the low-risk patients, 55 (89%) received first-line single-agent methotrexate and 38 (69%) patients achieved remission. Among those with high risk, 6 patients received induction chemotherapy (cisplatin and etoposide). Forty-two out of 54 (78%) achieved remission with first-line EMACO. Five patients needed angioembolisation and another 5 radiotherapy for control of bleeding. There were 12 deaths (8%), of which 1 was due to toxicity, 4 to acute bleeding, and 7 to disease progression. At 5 years, DFS was 88% (95% CI 82%–94%) and OS was 90% (95% CI 85%–96%). Thirty (21%) patients had undergone hysterectomy, of which 23 were done at a peripheral hospital and 12 were due to bleeding. In the rest within the data available, 74 (70%) resumed menstruation; 40 conceived, of which there were 8 abortions, 3 molar pregnancy, and 22 successful pregnancy outcomes. Conclusion: Most GTN patients were socioeconomically challenged and had high-risk disease. The outcomes were acceptable although a lot of work still needs to be done.
TMC TMH
Tags from this library: No tags from this library for this title. Add tag(s)
Log in to add tags.
    average rating: 0.0 (0 votes)
Item type Current location Call number Status Date due Barcode
Articles Articles Tata Memorial Hospital
Available AR20633

51st Annual Meeting of the Society of Gynecologic Oncology

Objective: Gestational trophoblastic neoplasia (GTN) is a rare
disease. The primary objective of the study was to evaluate diseasefree survival (DFS), and the secondary objective was to analyze clinical and socioeconomic characteristics, chemotherapy response, reproductive outcome, and overall survival (OS).
Method: This was a single-institution retrospective study in a tertiary care cancer center in India. All patients diagnosed with GTN from January 2009 to December 2014 at our hospital were evaluated. Data were retrieved from case files and electronic medical records. The data were analyzed using SPSS v23.0. DFS and OS were estimated by the Kaplan–Meier method.
Results: A total of 153 patients were diagnosed with GTN during this period, of which 136 (89%) were from a socioeconomically challenged background. The median age of the patients was 28 years (range 18–54 years). The median β hCG was 53726 IU/ml (range 18–10440587). These data were analyzed for 143 patients after excluding 10 patients lost to follow-up immediately after diagnosis. The median duration of follow-up was 63months. Sixty-two (43%) patients were low risk and 79 (55%)
were high risk, while data were not available for 2 patients. Among the low-risk patients, 55 (89%) received first-line single-agent methotrexate and 38 (69%) patients achieved remission. Among those with high risk, 6 patients received induction chemotherapy (cisplatin and etoposide). Forty-two out of 54 (78%) achieved remission with first-line EMACO. Five patients needed angioembolisation and another 5 radiotherapy for control of bleeding. There were 12 deaths (8%), of
which 1 was due to toxicity, 4 to acute bleeding, and 7 to disease progression. At 5 years, DFS was 88% (95% CI 82%–94%) and OS was 90% (95% CI 85%–96%). Thirty (21%) patients had undergone hysterectomy, of which 23 were done at a peripheral hospital and 12 were due to bleeding. In the rest within the data available, 74 (70%) resumed menstruation; 40 conceived, of which there were 8 abortions, 3 molar pregnancy, and 22 successful pregnancy outcomes.
Conclusion: Most GTN patients were socioeconomically challenged and had high-risk disease. The outcomes were acceptable although a lot of work still needs to be done.

There are no comments for this item.

Log in to your account to post a comment.

Powered by Koha