[Evaluation of treatment relating to gestational trophoblastic tumor registered to the French Trophoblastic Disease Reference Center (TDRC) in Lyon from 1999 to 2005].
OBJECTIVE
The aim of this study was both to analyse if gestational trophoblastic neoplasia (GTN) registered to the French Trophoblastic Disease Reference Center (TDRC) in Lyon (France) were managed according to the FIGO criteria for diagnosis of GTN and if chemotherapy was adapted to the 2000 FIGO prognostic scoring system.


METHODS
Retrospective, descriptive analysis of 167 GTN registered to GTC of Lyon between 1999 and 2005.


RESULTS
On the one hand, 66% of women (104/158) had a diagnosis of GTN according to FIGO criteria. One third (n=54) of the patients therefore had a premature or erroneous diagnosis of a tumor, when the treatment started. No supporting element of this premature diagnosis has been found out for 26 patients. The identification of lung and vaginal metastasis and histological diagnosis of invasive mole appeared as the most mentioned inappropriate criteria for diagnosis. On the other hand, chemotherapy was adapted to 2000 FIGO scoring in 91, 5% of cases. Twelve low risk GTN were treated with polychemotherapy and two high risk GTN were treated with monochemotherapy. Moreover 29% of the patients received a non adequate treatment due to deviations from the recommended protocol.


CONCLUSIONS
Non respect of FIGO criteria for the diagnosis of GTN can lead to erroneous diagnosis of tumors. Identification of lung or vaginal metastasis or diagnosis of invasive mole should not automatically justify the diagnosis of gestational trophoblastic neoplasia if the decrease in HCG occurs properly. Respect of FIGO criteria for the diagnosis of GTN and adaptation of chemotherapy to 2000 FIGO scoring are necessary to avoid inadequate treatment of gestational trophoblastic neoplasia.
Golfier
F
F
Service de Gynécologie-Obstétrique, Centre de Référence des Maladies Trophoblastiques, Hôtel-Dieu, 1, place de l'Hôpital, 69002 Lyon, France.
Labrousse
C
C
Frappart
L
L
Mathian
B
B
Guastalla
J-P
JP
Trillet-Lenoir
V
V
Hajri
T
T
Schott
A-M
AM
Raudrant
D
D
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D005260:Female; D005602:France; D031901:Gestational Trophoblastic Disease / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D009367:Neoplasm Staging; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology
D000970:Antineoplastic Agents