title: Timing of Referral to the New England Trophoblastic Disease Center: Does Referral with Molar Pregnancy Versus Postmolar Gestational Trophoblastic Neoplasia Affect Outcomes?
abstract: OBJECTIVE
  To assess if referral of patients with molar pregnancy who then developed postmolar gestational trophoblastic neoplasia (PMGTN) is associated with different outcomes when compared to referral of patients already with a diagnosis of PMGTN.
  
  
  METHODS
  The records of the New England Trophoblastic Disease Center (NETDC) were queried for all patients with molar pregnancy or PMGTN from 1993-2013. Retrospective chart review was performed to extract relevant clinical and demographic data. Parametric and nonparametric tests were utilized to compare variables.
  
  
  RESULTS
  From 1993-2013, 429 women with molar disease were evaluated at the NETDC. Of those, 68% were referred with molar pregnancy and 32% were referred with PMGTN. Comparing women with PMGTN who were referred with a molar pregnancy versus referred with PMGTN, the women were of equivalent stage and World Health Organization (WHO) score. Additionally, referral with molar pregnancy or PMGTN did not associate with time to persistence, time to remission, or number of lines of chemotherapy administered.
  
  
  CONCLUSIONS
  In this trophoblastic disease specialty center in the United States, referral at the time of PMGTN as opposed to at diagnosis of molar pregnancy did not appear to affect the stage or WHO score at diagnosis, the need for multiple chemotherapy lines, or time to remission.
authors.forename: Elisabeth J
authors.initials: EJ
authors.lastname: Diver
authors.forename: Neil S
authors.initials: NS
authors.lastname: Horowitz
authors.forename: Donald P
authors.initials: DP
authors.lastname: Goldstein
authors.forename: Marilyn
authors.initials: M
authors.lastname: Bernstein
authors.forename: Ross S
authors.initials: RS
authors.lastname: Berkowitz
authors.forename: Whitfield B
authors.initials: WB
authors.lastname: Growdon
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000188:drug therapy*; D006801:Humans; D006828:Hydatidiform Mole / Q000188:drug therapy*; D009511:New England; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D013997:Time Factors; D014594:Uterine Neoplasms / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents