OUTCOME OF TREATMENT OF GESTATIONAL TROPHOBLASTIC DISEASES IN HMC

ABSTRACT
Objective: The objective of this study is to know the prognosis of the patients turning up in the tertiary care hospital
with Gestational trophoblastic disease.
Method: This was a descriptive study done on patients with gestational trophoblastic disease presenting in the Gynae-
A Unit of Hayatabad Medical Complex Peshawar, between January 2009 to December, 2010, diagnosed on the
basis of clinical course and elevated level of HCG. Metastatic evaluation of the disease was done to assign different
risk groups to the patients before selecting appropriate chemotherapy regimen for each patient. Results of the therapy
were monitored by serial estimation of HCG levels. A questionnaire was developed on which the data was transferred
from the patient charts.
Results: There were a total of 1030 obstetric admissions during the study period, which included 34 cases of trophoblastic
disease. Hence, frequency of GTD was 1 per 45 live births. Of these 23 cases, 19 (82.6%) patients had hydatidiform
mole and 4 patients had malignant trophoblastic disease. Eight patients (34.7%) received chemotherapy while rest of
the patients had suction evacuation and follow-up.14 patients (40%) were low risk and 20 (60%) were high risk cases.
EMA-CO (Etoposide, Methotrexate, Actinomycin-D, Cytocine, Oncovine) regimen was administered to all patients.
Among all patients, 32 (91.3%) fully recovered and 2 (8.69%) died because of extensive disease/ metastasis. Overall
cure rate was 96% (4 patients survived out of 5 at two years’ follow-up).
Conclusion: Prognosis of gestational trophoblastic disease is favourable provided the appropriate therapy is administered
early in the course of disease. Provision of free medical care should be considered for these patients to save