A RETROSPECTIVE STUDY OF GESTATIONAL TROPHOBLASTIC NEOPLASIA IN A TERTIARY CARE CENTRE

INTRODUCTION: Gestational trophoblastic neoplasia refers to the malignant spectrum of gestational trophoblastic diseases which include the invasive mole, choriocarcinoma and the very rare placental site trophoblastic tumour. It occurs when the normal regulatory mechanisms controlling the proliferation and invasiveness of trophoblastic tissue are lost. Chemotherapy is the best modality of treatment and response to treatment is monitored by hCG surveillance. OBJECTIVES: To study the characteristics of gestational trophoblastic neoplasia including high risk factors, its transformation and progression, response to chemotherapy and prognosis. MATERIALS AND METHODS: Case records of the patients with gestational trophoblastic neoplasia were analysed retrospectively. The study period was for 5 years from January 2006 to December 2010. RESULTS: There were 422 patients with gestational trophoblastic disease during the study period. Out of this 22.03% of patients progressed to GTN. 5 patients had metastatic disease. 69.95% of the patients were between 20 and 35 years of age and 83.3% had an initial high levels of hCG. Majority of the patients with GTN were nulliparous or grand multiparous. 94.25% patients responded to single agent chemotherapy with methotrexate. Case fatality was 2.15%. CONCLUSION: Incidence of GTD was higher compared to international studies. If recognized in time and treated appropriately GTN is amenable to treatment with good cure rates.