TITLE:
Gestational Trophoblastic Neoplasia: Clinical and Therapeutic Profile in Madagascar
AUTHORS:
Norosoa Randriamaroson, Malala Razakanaivo, Ny Ony Andrianandrasana, Zo Ambinintsoa Solofonirina, Florine Rafaramino
KEYWORDS:
Choriocarcinoma, Gestational Trophoblastic Disease, Gestational Trophoblastic Neoplasia, Madagascar
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.10 No.7,
July
24,
2020
ABSTRACT: Gestational trophoblastic disease (GTD) develops from abnormal cellular
proliferation of trophoblasts following fertilization. This
includes complete and partial hydatidiform
mole (HM) and gestational trophoblastic neoplasia (GTN). The aim of this study was to report the
epidemiological, clinical and therapeutic profile of gestational
trophoblastic neoplasia (GTN) over period of ten years in the department of
Oncology Radiotherapy at the University Hospital Joseph Ravoahangy Andrianavalona (HJRA) Antananarivo Madagascar.
Medical records of women diagnosed with GTD in the department of Oncology
Radiotherapy at HJRA from January 1st, 2007 to September 2017 were retrospectively
reviewed. Only patients with the FIGO diagnosis GTN were included, while those with the histological
diagnosis of hydatidiform mole (HM), also sometimes classified as GTD,
were not included in this study. Also excluded were all cases with incomplete or missing data. Twenty four patients
were included. Median age of patients at the time of diagnosis was 37 years
(range 18 - 60). Most patients developed GTN following molar pregnancy (75%),
had disease duration from antecedent pregnancy of less than 6 months (58.20%), and had the pre-treatment hCG level
more than 10,000 IU/L (58.27%). At diagnosis, 14 patients (58.33%) had
localized disease (M0). Most common metastatic sites at initial diagnosis were
the liver and brain (20.83%). After a median follow-up from initial diagnosis
of six months (range 1 - 24), 58.33% were lost to follow up. This represented
an increase in the percentage of patients lost to follow up prior to completion
of therapy, when compared with our previous results for an earlier time period.
GTN in Malagasy woman displays an aggressive
clinic profile. Finding ways to increase treatment compliance provides
the best way to minimize recurrences of this potentially deadly disease.