Outcomes of Treatment of Gestational Trophoblastic Neoplasia in a Primarily Indigent Urban Population
Davidson, B.A.; Nagel, C.I.; Richardson, D.L.; Kehoe, S.M.; Miller, D.S.; Lea, J.S.
Journal of Reproductive Medicine 60(5-6): 243-248
2015
ISSN/ISBN: 0024-7758 PMID: 26126310 Document Number: 683623
To review outcomes of women with gestational trophoblastic neoplasia (GTN) who presented to an inner-city hospital system, given that the rigorous treatment and follow-up for GTN is often problematic for certain women of low socioeconomic status with limited resources and social support. A retrospective review was performed with IRB approval of patients diagnosed with GTN based on the revised WHO scoring system from 1999-2010 at our institution. SPSS Statistics software was used to perform univariate and multivariate analyses. Forty-nine patients were treated for GTN: 32 low-risk and 17 high-risk. Low-risk patients received an average of 5 cycles of initial single-agent chemotherapy. Six patients had persistent disease and were switched to a second single-agent regimen. One patient required multiagent chemotherapy for normalization of human chorionic gonadotropin levels. No patient had recurrence of disease. All high-risk patients were initially treated with multiagent chemotherapy, averaging 8 cycles. Two of the 17 patients persisted; 1 recurred. All 3 currently have no evidence of disease. No patient died of disease. Excellent treatment outcomes in patients with GTN may be achieved in disadvantaged populations when compliance to regimens is optimized.