Iranian Society of Gynecology Oncology

Authors

1 Department of Obstetrics and Gynecology, Preventative Gynecology Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran

2 Department of Obstetrics and Gynecology, Kashan University of Medical Sciences, Kashan, IR Iran

3 Department of Pathology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran

4 Department of Obstetrics and Gynecology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran

Abstract

Background and Objective: Most gestational trophoblastic neoplasias (GTN) develop following hydatidiform mole; but may occur after abortion, normal pregnancy or even ectopic pregnancy.
Objectives: The aim of this study was to assess the importance of six-month follow-up of uncomplicated molar pregnancy after achieving undetectable β-human chorionic gonadotropin (β-hCG) levels.
Methods: In this retrospective study, molar pregnancies with negative β-hCG were compared with those with positive β-hCG during a six-month follow-up.
Results: A total of 279 women with molar pregnancy, treated at two referral university hospitals in Tehran were analyzed and 86 patients (31%) who had completed their follow-up period were included. Of the evaluated patients (n = 86), the pathology report indicated complete mole for 66 patients (77%) and partial mole for 20 patients (23%). All 86 patients had achieved at least one undetectable β-hCG level during their follow up, and none showed evidence of relapse.
Conclusions: We found that in patients with uncomplicated molar pregnancy, relapse is unlikely after achieving undetectable serum β-hCG levels. Further investigations with larger sample sizes and preferably prospective design are needed to make a definite conclusion.

Keywords

  1. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams Obstetrics. 23 ed. New York, NY: McGraw- Hill Companies; 2010.
  2. Gibbs R, Karlan B, Haney R, Nygaard I. Danforth's Obstetrics and Gynecology. Philadelphia, PA: Lippincott Williams and Wilkins; 2008.
  3. Shahverdi Z, Farzaneh F, Hosseini MS, Mashhoory A. Gestational trophoblastic disease as seen in a university teaching hospital: a 5 year review. 13th Biennial Meeting of the International Gynecologic Cancer Society (IGCS 2010). Prague, Czech Republic.
  4. Javey H, Sajadi H. Hydatidiform mole in southern Iran: a statistical survey of 113 cases. Int J Gynaecol Obstet. 1978;15(5):390-5. [DOI:10.1002/j.1879-3479.1977.tb00716.x]
  5. Rezavand N, Seyedzadeh SA. Study of hydatiform mole frequency and some relative risk factors [in Persian]. J Ham Uni Med Sci. 2009;16(3):27-32.
  6. Novak E, Berek JS. Berek and Novak's Gynecology. 15 ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2007.
  7. Berek JS, Hacker NF. Berek and Hacker's Gynecologic Oncology. Philadelphia, PA: Lippincott Williams and Wilkins; 2009.
  8. Seckl MJ, Fisher RA, Salerno G, Rees H, Paradinas FJ, Foskett M, et al. Choriocarcinoma and partial hydatidiform moles. Lancet. 2000;356(9223):36-9. [DOI:10.1016/S0140-6736(00)02432-6]
  9. Mungan T, Kuscu E, Dabakoglu T, Senoz S, Ugur M, Cobanoglu O. Hydatidiform mole: clinical analysis of 310 patients. Int J Gynaecol Obstet. 1996;52(3):233-6. [DOI:10.1016/0020-7292(95)02608-8]
  10. Berkowitz RS, Goldstein DP. Chorionic tumors. N Engl Med. 1996;335(23):1740-8. [DOI:10.1056/NEJM199612053352306]
  11. Bolis G, Belloni C, Bonazzi C, Mangili G, Presti M, Zanaboni F, et al. Analysis of 309 cases after hydatidiform mole: different follow up program according to biologic behavior. Tumori. 1988;74(1):93-6. [DOI:10.1177/030089168807400116]
  12. Growdon WB, Wolfberg AJ, Feltmate CM, Goldstein DP, Genest DR, Chinchilla ME, et al. Postevacuation hCG levels and risk of gestational trophoblastic neoplasia among women with partial molar pregnancies. J Reprod Med. 2006;51(11):871-4.
  13. Wolfberg AJ, Feltmate C, Goldstein DP, Berkowitz RS, Lieberman E. Low risk of relapse after achieving undetectable HCG levels in women with complete molar pregnancy. Obstet Gynecol. 2004;104(3):551-4. [DOI:10.1097/01.AOG.0000136099.21216.45]
  14. Feltmate CM, Batorfi J, Fulop V, Goldstein DP, Doszpod J, Berkowitz RS. Human chorionic gonadotropin follow-up in patients with molar pregnancy: a time for reevaluation. Obstet Gynecol. 2003;101(4):732-6. https://doi.org/10.1097/00006250-200304000-00020 [DOI:10.1016/S0029-7844(03)00009-7]