Objective: To study patients' characteristics, patterns and results of treatment of nonmetastatic gestational trophoblastic tumor
Materials and Methods: We reviewed the medical records of 56 patients with nonmetastatic gestational trophoblastic tumor admitted to Songklanagarind Hospital from January 1989 to December 2000. Age, presenting symptoms, parity, nature of antecedent pregnancy, duration of disease, pretreatment serum hCG level, size of tumor, the International Federation of Gynecology and Obstetrics substage, and the World Health Organization scores were studied. Patterns and responses of treatment were evaluated.
Results: Mean age of the patients was 31.3 years (16-54). The most common presenting symptom was vaginal bleeding. Seventy-nine percent developed their disease after molar pregnancy. Mean duration of disease was 23.5 months with a range of 1 to 240 months. Pretreatment hCG level ranged from 26 to 758,846 mIU/ml with a mean of 69,828 mIU/ml. The percentages of patients in FIGO substage a, b, c were 66.1, 21.4, and 12.5 respectively. Mean modified WHO score was 3.75 (0-13). Patients' characteristics in the later 5-year period were not different from those in the first 7-year period. Treatment included single agent chemotherapy (75.0%), multiple agent chemotherapy (10.7%), chemotherapy combined with surgery (10.7%) and surgery alone (1.8%). Mean courses of maintenance chemotherapy was 1.7. The overall remission rate was 72.7%.
Conclusion: Patients' characteristics were unchanged over a 12-year period. Although there was variation in treatment protocol, the overall remission rate was acceptable.