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- Title
Can Laboratory and Clinical Signs Predict Persistence in Gestational Trophoblastic Disease?
- Authors
Köşüş, Nermin; Çelik, Çetin; Köşüş, Aydın
- Abstract
Purpose: Laboratory and clinical signs of gestational trophoblastic disease (GTD) and their importance in the prediction of persistence of this disease were evaluated. Material and Methods: Ninety-two patients with GTD were evaluated prospectively. Patients were divided into four groups as complete mole, partial mole, invasive mole and choriocarcinoma. All patients were evaluated for persistence by clinical, ultrasound and laboratory findings. Methotrexate+folinic acid were administered to the patients with persistent disease. Combined chemotherapy protocols were applied to patients with no mor minimum response. Hysterectomy was performed on older patients who had no desire for a child. Results: Molar pregnancy and gestational choriocarcinoma rates were 4.8/1000 and 2/10,000 respectively. Mean age and mean beta-hCG levels were higher in the invasive mole group. Theca.lutein cysts and excessive uterine enlargement were detected in a higher proportion of patients with complete or invasive mole. These findings were seen more frequently in cases with persistence. Conclusion: Persistent GTD can be predicted by clinical and biochemical markers. Risk of the development of persistence is lower in patients under the age of 35, in the absence of theca-lutein cysts and hCG level below 100,000 IU. In addition, negative predictive value of hCG level shows low risk of persistence to the same extent as negative predictive value of combination of parameters. With early detection and effective treatment, prognosis is excellent.
- Subjects
MEDICAL imaging systems; NEVUS; DRUG therapy; CANCER; SKIN cancer; TUMORS; SKIN care; FOLINIC acid; ANTINEOPLASTIC agents; DISEASES
- Publication
Erciyes Medical Journal / Erciyes Tip Dergisi, 2008, Vol 30, Issue 1, p57
- ISSN
2149-2247
- Publication type
Article