5. GESTATIONAL TROPHOBLAST NEOPLASIA AND MORTALITY RISK FACTORS

Arzoo Gul Bangash, Rabeea Sadaf, Mehr-un-Nisa

Department of Obstetrics and Gynaecology, Hayatabad, Medical Complex, Peshawar - Pakistan

Abstract

Objective: To analyze the risk factors associated with mortality in patients receiving treatment for Gestational Trophoblast
Neoplasia (GTN).
Material and Methods: Rertospective, cross- sectional study done at Department of Obstetrics and Gynaecology,
Hayatabad Medical Complex, Peshawar, Pakistan, from June 2005 to June 2014. Ninety women with the diagnosis of
GTN were hospitalized and treated according to standard chemotherapeutic regimens. Hospital records of patients
demographic profile, age, parity, antecedent pregnancy, serum ?-hCG levels, site of metastasis, FIGO score, type of
chemotherapy, and treatment outcomes including mortality were studied. Data analysis done through SPSS 16.
Results: In 90 patients diagnosed with GTN, 59(65.6%) patients were low risk and 31(34.4 %) were in high risk category.
Nine out of 90 patients diagnosed with GTN died during initial treatment giving overall mortality of 10%. All patients
who died were in high risk category with stage IV GTN. Six out of nine patients had term pregnancy as antecedent
pregnancy. Five out of 9 patients that died had serum ?-hCG levels of >100000IU/ml. Eight out 9 patients had FIGO
scored between 9-12. Metastasis was present in all the patients that died. Three patients had metastasis present both
in Brain and Liver and two had metastasis only in liver, while other two had lung metastasis.
Conclusions: High FIGO score, high pretreatment serum ?-hCG levels, previous term pregnancy, liver and brain metastasis
have been associated with adverse outcome like mortality in patients with gestational trophoblast neoplasia:
a rare but highly curable malignancy.

Keywords: Gestational, Trophoblast Neoplasia, FIGO Prognostic score (International federation of Gynaecologistand Obstetrician), Mortality, Chemotherapy.

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