Prophylactic chemotherapy for hydatidiform mole. Five to 15 years follow-up.
The effectiveness of the prophylactic chemotherapy was evaluated in 420 patients with molar pregnancy. All patients were followed for 5 to 15 years after the evacuation. Twenty-two (7.5%) of 293 patients with prophylactic chemotherapy and 23 (18.1%) of 127 patients without prophylactic chemotherapy (control) developed secondary trophoblastic disease. The prophylactic chemotherapy could reduce the occurrence of secondary trophoblastic disease. In these secondary trophoblastic diseases, 5 (22.7%) of 22 patients in the prophylactic chemotherapy group and 5 (21.7%) of 23 in the control had metastatic trophoblastic disease. Choriocarcinoma after the molar pregnancy developed in two patients (0.7%) of the prophylactic chemotherapy group and two (1.6%) of the control. Prophylactic chemotherapy did not eliminate the occurrence of choriocarcinoma. The complication of the prophylactic chemotherapy was seen in 27.3% of the patients. Neither severe complication nor death were related to the toxicity.
D000293:Adolescent; D000328:Adult; D002822:Choriocarcinoma / Q000453:epidemiology / Q000517:prevention & control* / Q000556:secondary; D006063:Chorionic Gonadotropin / Q000652:urine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006828:Hydatidiform Mole / Q000188:drug therapy*; D007564:Japan; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors; D014328:Trophoblastic Neoplasms / Q000453:epidemiology / Q000517:prevention & control* / Q000556:secondary; D014594:Uterine Neoplasms / Q000188:drug therapy*
D006063:Chorionic Gonadotropin; D008727:Methotrexate