Gestational Trophoblastic Disease Diagnosis and Treatment: An Analysis of 56 Cases

ObjectiveTo investigate the diagnosis and treatment of gestational trophoblastic disease (GTD).MethodsA retrospective review was conducted on 56 patients with GTD who underwent treatment in Ruijin hospital from January 2007 to December 2012. Their information of diagnosis, treatments, follow-up and efficacy were collected and analyzed.ResultsMisdiagnosis rate was 41.1% (23/56) for the first time. Of 56 patients, 31 had direct curettage, 19 had curettage after trichosanthis (TCS) treatment, 3 had curettage after intervention treatment and 3 did not have curettage. Twenty patients with gestational trophoblastic neoplasia (GTN) took fluorouracil+vincristine+dactinomycin (VCR+KSM+5-FU) chemotherapy, but 2 of them changed to etoposide+methotrexate+actinomycetes streptozotocin-D+cyclophosphamide+vincristine (EMA-CO) chemotherapy due to drug resistance. Three patients with GTN took EMA-CO chemotherapy. Two patients with placental site trophoblastic tumor (PSTT) required surgeries, one took hysterectomy, another got mass and adnexectomy. Apart from 1 case who gave up treatment and was dead, all the other women went into remission from their diseases.ConclusionThe diagnosis of trophoblastic disease rely on a comprehensive analysis. A reasonable choice of TCS or intervention can be effective and safe in treating GTD. Most patients with GTN could get complete remission by selecting the appropriate chemotherapy and surgery.