Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access
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Original Article

Volume 12, Number 2, August 2023, pages 46-51

Prognostic Scoring and Outcome of Gestational Trophoblastic Disease Patients

Tables

Table 1. Characteristics of Gestational Trophoblastic Patients
 
CharacteristicTotal cases (n = 56)
FIGO: International Federation of Gynecology and Obstetrics; EMA-CO: etoposide, methotrexate, dactinomycin, cyclophosphamide, vincristine; hCG: human chorionic gonadotropin.
Age at diagnosis (years), median32.5
  < 40 years, n (%)40 (71.4)
  > 40 years, n (%)16 (28.6)
Median time between last pregnancy and start treatment (month)1
Median hCG level before treatment (mIU/mL)12,490
FIGO score, n (%)
  < 747 (83.9)
  7 - 129 (16.1)
Antecedent pregnancy, n (%)
  Molar pregnancy56 (100)
Pretreatment hCG level (mIU/mL), n (%)
  < 1,0007 (12.5)
  > 1,000 - 10,00021 (37.5)
  > 10,000 - 1,000,00017 (30.36)
  > 100,00011 (19.64)
Operation, n (%)
  Suctional curettage51 (91)
  Hysterectomy5 (9)
Histopathology, n (%)
  Hydatidiform mole52 (92.8)
  Choriocarcinoma2 (3.6)
  Placental site trophoblastic tumor (PSTT)2 (3.6)
Site of metastasis, n (%)
  Lung15 (26.78)
  Brain1 (1.78)
Treatment, n (%)
  Actinomycin-D48 (85.7)
  Methotrexate-folinic acid2 (3.6)
  EMA-CO6 (10.7)

 

Table 2. A Literature Review of the Ultra-High-Risk Score ≥ 13 and Brain Metastasis Choriocarcinoma
 
Author (year of published)CountryYear of treatmentUltra-high-risk score ≥ 13 (n)Brain metastasis (n)TreatmentStatus n, (%)
EMA-CO: etoposide, methotrexate, dactinomycin, cyclophosphamide, vincristine; EMA-EP: etoposide, methotrexate, dactinomycin, etoposide, cisplatin; APE: dactinomycin, cisplatin, etoposide; FA: 5-fluorouracil, actinomycin-D, FCA: 5-fluorouracil, cyclophosphamide, actinomycin-D; FCA: floxuridine, etoposide, cisplatin; ACM: actinomycin-D, cyclophosphamide, methotrexate; FAEV: floxuridine, dactinomycin, etoposide, vincristine; 5-FU: fluorouracil; TE/TP: paclitaxel, etoposide/paclitaxel, cisplatin; FIGO: International Federation of Gynecology and Obstetrics.
Yang et al, 2005 [18]China1985 - 2004Not classified13Craniotomy and EMA-CODeath in brain metastasis 3/13
Whitaker et al, 2015 [10]UK201111EMA-COAlive
Xiao et al, 2015 [11]China1990 - 201363109EMA-CO, FAEV, 5-FUDeath in brain metastasis 34/109
Savage et al, 2015 [12]UK1991 - 20132227EMA-CO, EMA-EPDeath in brain metastasis 4/27
Bolze et al, 2016 [9]France1999 - 201429/97417EMA-COFIGO score ≥ 13 14/29 (48%)
Total death 18/941
Total death in FIGO score ≥ 13 (11/29)
Yujia et al, 2017 [19]China2002 - 201514358FAEV, EMA-CO, EMA-EP, TE/TP, intrathecal methotrexateDeath 46/143
Makhathini et al, 2019 [4]South Africa2013 - 20179/63Not classifiedNot classifiedDeath 3/63 (4.8)
Gavanier et al, 2019 [7]France1999 - 20161721EMA-CO, EMA-EP, APEDeath in brain metastasis 6/21 (28.57)
Zhang et al, 2019 [17]USA2014 - 2018Not classified3Not classifiedNot classified
Maesta et al, 2020 [5]Brazil1990 - 201436/147Not classifiedEMA-CODeath 19/147 (12.9)
Death in FIGO score ≥ 12 13/36 (36.1%)
Dombrovsky et al, 2020 [16]USA202011Craniotomy and EMA-COAlive
Wang et al, 2021 [8]China1999 - 2019614EMA-CO, EMA-EP, FA, ACM, FCA, FEPDeath in stage IV 7/26 (26.92%)
Li et al, 2022 [13]China1990 - 201821/3514635 craniotomiesDeath in brain metastasis with craniotomy 6/35
Present study (2023)Thailand2012 - 2022None1Craniotomy, whole brain radiotherapy and EMA-COAlive