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THE CHARACTERISTICS OF INVASIVE MOLE AT TU DU HOSPITAL
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Abstract
Background: Invasive mole (IM) is a subtype of gestational trophoblastic neoplasms (GTNs). GTN is a group of malignant diseases that can be cured even if metastasized. Hysterectomy is not the most common, primary hysterectomy should be as part of primary treatment for women with low-risk nonmetastatic GTN and no desire for future fertility. Delayed hysterectomy is often considered for patients who fail to respond to primary chemotherapy. Objective: The study aimed to determine the rate of requiring salvage chemotherapy and associated factors in IM. Methods: This study was carried out at the TuDu hospital which has been receiving a totally 189 patients diagnosed based on histology by hysterectomy from 01/2016 to 12/2020. Results: Followed-up by 12 months, 47 patients required salvage chemotherapy. The incidence was 24.87% (95%CI: 18.88-31.66). Applying multivariate model, prophylactic chemotherapy (HR = 2.75, 95%Cl: 1.20-6.30) and 2 weeks hCG follow-up value greater than 1900 mIU/mL (HR = 4.30, 95%Cl: 2.08-8.87) increasing the risk of requirement salvage chemotherapy. Postoperative chemotherapy decreasing the risk (HR = 0.43, 95%Cl: 0.22-0.83). Conclusions: Although patients were treated by hysterectomy, 24.87% patients needed salvage chemotherapy to reach hCG normalization. This prove the malignant of invasive mole. It is not purely a local invasion of molar villi. Postoperative chemotherapy has an important role in diminishing the rate of requiring salvage chemotherapy.
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Keywords
Invasive mole, gestational trophoblastic neoplasia, hysterectomy, postoperative chemotherapy, salvage chemotherapy
References
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