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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
2. Rim Batti, Amina Mokrani, Haifa Rachdi, Henda Raies, Omar Touhami, et al. (2019), "Gestational trophoblastic neoplasia: experience at Salah Azaiez Institute". The Pan African medical journal, 33, pp. 121-121.
3. Pierre-Adrien Bolze, Mélodie Mathe, Touria Hajri, Benoit You, Yohann Dabi, et al. (2018), "First-line hysterectomy for women with low-risk non-metastatic gestational trophoblastic neoplasia no longer wishing to conceive". Gynecologic Oncology, 150 (2), pp. 282-287.
4. R. M. Clark, N. S. Nevadunsky, S. Ghosh, D. P. Goldstein, R. S. Berkowitz (2010), "The evolving role of hysterectomy in gestational trophoblastic neoplasia at the New England Trophoblastic Disease Center". J Reprod Med, 55 (5-6), pp. 194-8.
5. V. Giorgione, A. Bergamini, R. Cioffi, F. Pella, E. Rabaiotti, et al. (2017), "Role of Surgery in the Management of Hydatidiform Mole in Elderly Patients: A Single-Center Clinical Experience". Int J Gynecol Cancer, 27 (3), pp. 550-553.
6. H. Y. S. Ngan, M. J. Seckl, R. S. Berkowitz, Y. Xiang, F. Golfier, et al. (2021), "Diagnosis and management of gestational trophoblastic disease: 2021 update". Int J Gynaecol Obstet, 155 Suppl 1, pp. 86-93.
7. P. Zhao, Y. Lu, W. Huang, B. Tong, W. Lu (2019), "Total hysterectomy versus uterine evacuation for preventing post-molar gestational trophoblastic neoplasia in patients who are at least 40 years old: a systematic review and meta-analysis". BMC Cancer, 19 (1), pp. 13.
8. Vo Minh Tuan, Phan Nguyen Nhat Le (2019), "First Line Mono-Chemotherapy using Methotrexate in Post-Molar Patients with Gestational Trophoblastic Neoplasia". Gynecol Reprod Health, 3 (2), pp. 1-5.