title: Epidemiological report on the treatment of patients with gestational trophoblastic disease in 10 Brazilian referral centers: results after 12 years since International FIGO 2000 Consensus.
abstract: OBJECTIVE
  To evaluate treatment of Brazilian patients with gestational trophoblastic disease (GTD).
  
  
  METHODS
  A retrospective cohort study with analysis of medical reports performed in 10 Brazilian referral centers from January 2000 to December 2011.
  
  
  RESULTS
  Of 5,250 patients 3 died (0.06%) at the time of uterine evacuation. Spontaneous remission of GTD (group G1) was observed in 4,103 cases, and 1,144 (21.8%) progressed to gestational trophoblastic neoplasia (GTN) (G2). In G1 2,716 (66.2%) had complete hydatidiform mole (HM) and 1,210, partial HM (29.5%); 3,772 patients (92.7%) recovered as noted in December 2012. In G2, of 1,118 patients treated, initial histopathological results of previous gestation were complete HM (77.5% [n = 886]), partial HM (8.8% [n = 100]), and choriocarcinoma (8.0% [n = 92]); 930 (81.3%) were low-risk, 200 (17.5%) were high-risk GTN, and 14 had placental site trophoblastic tumor (PSTT) (1.2%); cure was achieved in 1,078 cases (96.4%), but 26 patients (2.3%) died (4 low-risk [0.4%], 19 high-risk [9.5%], and 3 PSTT [21.4%]).
  
  
  CONCLUSIONS
  The highest death rates were due to high-risk GTN and PSTT. Patients with molar pregnancy should be referred to a referral center for an early diagnosis and prompt treatment of GTN in order to reduce the morbidity and mortality found in advanced stages.
authors.forename: Antonio
authors.initials: A
authors.lastname: Braga
authors.forename: Elza Maria Hartmann
authors.initials: EM
authors.lastname: Uberti
authors.forename: Maria do Carmo
authors.initials: Mdo C
authors.lastname: Fajardo
authors.forename: Maurício
authors.initials: M
authors.lastname: Viggiano
authors.forename: Sue Yazaki
authors.initials: SY
authors.lastname: Sun
authors.forename: Bruno Maurizio
authors.initials: BM
authors.lastname: Grillo
authors.forename: Sérgio Lunardon
authors.initials: SL
authors.lastname: Padilha
authors.forename: Jurandyr Moreira
authors.initials: JM
authors.lastname: de Andrade
authors.forename: Christiani Bisinoto
authors.initials: CB
authors.lastname: de Souza
authors.forename: José Mauro
authors.initials: JM
authors.lastname: Madi
authors.forename: Izildinha
authors.initials: I
authors.lastname: Maestá
authors.forename: Eduardo
authors.initials: E
authors.lastname: Silveira
mesh_terms: D005260:Female; D006801:Humans; D011247:Pregnancy; D001938:Brazil / Q000453:epidemiology; D002822:Choriocarcinoma / Q000453:epidemiology / Q000628:therapy; D015331:Cohort Studies; D031901:Gestational Trophoblastic Disease / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D006828:Hydatidiform Mole / Q000453:epidemiology / Q000628:therapy; D009367:Neoplasm Staging; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D012307:Risk Factors; D018245:Trophoblastic Tumor, Placental Site / Q000453:epidemiology / Q000628:therapy; D014594:Uterine Neoplasms / Q000453:epidemiology / Q000628:therapy; D003245:Consensus Statements as Topic