Clinical Study

BJC Open article

British Journal of Cancer (2012) 107, 1810–1814. doi:10.1038/bjc.2012.462 www.bjcancer.com
Published online 11 October 2012

Treatment outcomes for 618 women with gestational trophoblastic tumours following a molar pregnancy at the Charing Cross Hospital, 2000–2009

A Sita-Lumsden1, D Short1, I Lindsay1, N J Sebire1, D Adjogatse1, M J Seckl1 and P M Savage1

1Department of Medical Oncology, Gestational Trophoblastic Disease Centre, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London W6 8RF, UK

Correspondence: Dr PM Savage, E-mail: philip.savage@imperial.nhs.uk

Received 26 June 2012; Revised 17 September 2012; Accepted 19 September 2012
Advance online publication 11 October 2012

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Abstract

Background:

  

Post-molar pregnancy gestational trophoblastic tumours (GTT) have been curable with chemotherapy treatment for over 50 years. Because of the rarity of the diagnosis, detailed structured information on prognosis, treatment escalations and outcome is limited.

Methods:

  

We have reviewed the demographics, prognostic variables, treatment course and clinical outcomes for the post-mole GTT patients treated at Charing Cross Hospital between 2000 and 2009.

Results:

  

Of the 618 women studied, 547 had a diagnosis of complete mole, 13 complete mole with a twin conception and 58 partial moles. At the commencement of treatment, 94% of patients were in the FIGO low-risk group (score 0–6). For patients treated with single-agent methotrexate, the primary cure rate ranged from 75% for a FIGO score of 0–1 through to 31% for those with a FIGO score of 6.

Conclusion:

  

In the setting of a formal follow-up programme, the expected cure rate for GTT after a molar pregnancy should be 100%. Prompt treatment and diagnosis should limit the exposure of most patients to combination chemotherapy. Because of the post-treatment relapse rate of 3% post-chemotherapy, hCG monitoring should be performed routinely.

Keywords:

gestational trophoblastic tumours; molar pregnancy; methotrexate resistance; demographics