A clinical study on gestational trophoblastic disease

Kim, Jong Hyun; Kim, Kwan Sik; Yang, Yoon Jeong; Tae, Cheol Min; Yoon, Seok Keun; Hur, Yoon Soo; Lee, Jeong Heon; Cho, Sung Nam; Oh, Byung Chan; Kim, Jong Duk

Abstract

OBJECTIVE
To evaluate the clinical characteristics and the outcome of the management for gestational trophoblastic disease (GTD) patients diagnosed at our hospital and to report the current situation of GTD in Korea.
METHODS
Between January, 1991, and December, 2000, One hundred and eleven women were diagnosed as GTD and managed in our hospital. Patients were classified according to clinical diagnosis and their medical records were investigated.
RESULTS
Cases of benign, malignant nonmetastatic, malignant metastatic low risk and malignant metastatic high risk GTDs were 62, 36, 2 and 11 respectively. The mean age (year), gravidity and parity (number) of GTD patients were 33.3+/-9.9 (range: 19-54), 3.2+/-3.0 (range: 0-16) and 1.7+/-1.8 (range: 0-7) overall. About 75% of GTD patients were women in their 20s and 30s, and 85% occurred in patients with parity of 3 or less. The most common prior gestational event was abortion (37.1%) for molar pregnancy and molar pregnancy (61.2%) for persistent gestational trophoblastic tumor (PGTT). The progression rate of molar pregnancies to PGTT was 38.0%. MTX (16.3%) was mainly used as a single agent, and EMACO (28.6%) or MAC (22.4%) were primarily used for multidrug chemotherapy for the treatment of PGTT. In the treatment of PGTT, overall remission rate was 95.9% (n=47/49).
CONCLUSION
The trends for GTD in Korea revealed significant changes, not only a decrease in the incidence of GTD, but also an improvement in the outcome of the management. There is a necessity of further community-based surveys for GTD.