The impact of uterine re-curettage, pre-evacuation and week-one level of hCG on the number of chemotherapy courses in treatment of post molar GTN

• Main Authors: Elhady Hemida, R. (Reda) abd, Toson, E. (Eman), Doorn, H.C. (Lena) van
• Format: Article in Journal/Newspaper
• Language: English
• Published: 2011
• Subjects: Gestational trophoblastic neoplasia; hCG; Re-curettage; GTN-P
• Online Access: http://repub.eur.nl/pub/85571

__Background:__ Post molar GTN was reported to occur in 7.5-20% of patients following evacuation of complete hydatidiform moles and in 2.5-7.5% following evacuation of partial moles. The role of uterine re-curettage in post molar GTN is not clear. __Objectives:__ Study of the correlation of pre-evacuation and week- one level of hCG, and uterine re-curettage to the number of chemotherapy courses in treatment of post molar GTN. __Patients and methods:__ This retrospective study included 29 cases of post molar GTN through reviewing their medical records. Results: There were 25 cases (86.21) of low risk, and 4 cases of high risk score (13.79%). The 3 year survival was 96.6%. There were non-significant correlation of age, parity, pre-evacuation level and hCG in week-1 to number of chemotherapy courses, while uterine recurettage was significantly correlated to number of chemotherapy courses (p=0.04). __Conclusion:__ Uterine re-curettage was significantly correlated to less number of chemotherapy courses in patients with post molar GTN (p=0.04). Pre-evacuation and week-1 hCG were not correlated to number of chemotherapy cycles. A large prospective randomized trial to clarify the beneficial effect of uterine re-curettage is recommended.