The impact of uterine re-curettage, pre-evacuation and week-one level of hCG on the number of chemotherapy courses in treatment of post molar GTN

J Exp Ther Oncol. 2011;9(3):217-20.

Abstract

Background: Post molar GTN was reported to occur in 7.5-20% of patients following evacuation of complete hydatidiform moles and in 2.5-7.5% following evacuation of partial moles. The role of uterine re-curettage in post molar GTN is not clear.

Objectives: Study of the correlation of pre-evacuation and week- one level of hCG, and uterine re-curettage to the number of chemotherapy courses in treatment of post molar GTN.

Patients and methods: This retrospective study included 29 cases of post molar GTN through reviewing their medical records.

Results: There were 25 cases (86.21) of low risk, and 4 cases of high risk score (13.79%). The 3 year survival was 96.6%. There were non-significant correlation of age, parity, pre-evacuation level and hCG in week-1 to number of chemotherapy courses, while uterine re-curettage was significantly correlated to number of chemotherapy courses (p = 0.04).

Conclusion: Uterine re-curettage was significantly correlated to less number of chemotherapy courses in patients with post molar GTN (p = 0.04). Pre-evacuation and week-1 hCG were not correlated to number of chemotherapy cycles. A large prospective randomized trial to clarify the beneficial effect of uterine re-curettage is recommended.

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor / blood*
  • Chorionic Gonadotropin / blood*
  • Cisplatin / administration & dosage
  • Dilatation and Curettage*
  • Doxorubicin / administration & dosage
  • Female
  • Humans
  • Hydatidiform Mole / blood
  • Hydatidiform Mole / drug therapy*
  • Hydatidiform Mole / surgery
  • Leucovorin / administration & dosage
  • Methotrexate / administration & dosage
  • Pregnancy
  • Retrospective Studies
  • Uterine Neoplasms / blood
  • Uterine Neoplasms / drug therapy*
  • Uterine Neoplasms / surgery
  • Young Adult

Substances

  • Biomarkers, Tumor
  • Chorionic Gonadotropin
  • Doxorubicin
  • Cisplatin
  • Leucovorin
  • Methotrexate