Gestational trophoblastic neoplasia: clinical trends in 8 years at Hospital Universitario de Caracas.
OBJECTIVE
To analyze the clinical trends of gestational trophoblastic neoplasia (GTN) at the Department of Obstetrics and Gynecology, Hospital Universitario de Caracas (HUC).


METHODS
A medical record review was performed of epidemiologic, clinical and diagnostic features of 25 cases of GTN at HUC from 1997 to 2004.


RESULTS
During the study period, 35,300 deliveries occurred, and 25 patients were diagnosed with GTN; the prevalence was 0.70:1,000 deliveries. The mean age was 29.2 years. Fifty-six percent were posthydatidiform mole (HM), 36% postchoriocarcinoma (CC), 4% postinvasive mole and 4% postabortion with abundant intermediate trophoblast. Vaginal bleeding was the main symptom in patients with CC. Two cases resembled ectopic pregnancy, and another resembled a vaginal endometrioma. Fifty-two percent of cases were at stage Ib; 76% received single-agent chemotherapy. Hysterectomy was performed in 6 cases. Twenty-one patients achieved remission, 2 showed regression and 2 died.


CONCLUSIONS
GTN had a high prevalence because HUC is a reference center. The most common presentation was post-HM GTN. Vaginal bleeding is frequent in CC and can mimic other gynecologic diseases. Chemotherapy is helpful, and hysterectomy can be performed in selected cases at early stages or with severe vaginal bleed-with a good ing. GTN has a good prognosis, and early diagnosis is possible.
Cortés-Charry
Rafael
R
Obstetrics and Gynecology Department, Hospital Universitario de Caracas and Oncology Institute, Caracas, Venezuela. rafacort083@cantv.net
Figueira
Lina M
LM
García-Barriola
Victoria
V
de Gómez
Miriam
M
Vivas
Zhari
Z
Salazar
Aleydah
A
D000328:Adult; D002822:Choriocarcinoma / Q000150:complications / Q000453:epidemiology*; D006063:Chorionic Gonadotropin / Q000097:blood; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000453:epidemiology* / Q000628:therapy; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D006828:Hydatidiform Mole / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D011247:Pregnancy; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000150:complications / Q000453:epidemiology; D014623:Vaginal Diseases / Q000209:etiology; D014687:Venezuela / Q000453:epidemiology
D006063:Chorionic Gonadotropin