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Multicenter Analysis of Gestational Trophoblastic Neoplasia in Turkey

  • Ozalp, Sabit Sinan (Department of Obstetrics and Gynecology, School of Medicine, Eskisehir Osmangazi University) ;
  • Telli, Elcin (Department of Obstetrics and Gynecology, School of Medicine, Eskisehir Osmangazi University) ;
  • Oge, Tufan (Department of Obstetrics and Gynecology, School of Medicine, Eskisehir Osmangazi University) ;
  • Tulunay, Gokhan (Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital) ;
  • Boran, Nurettin (Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital) ;
  • Turan, Taner (Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital) ;
  • Yenen, Mufit (Department of Obstetrics and Gynecology, Gulhane Military Medical Academy and Medical School) ;
  • Kurdoglu, Zehra (Department of Obstetrics and Gynecology, School of Medicine, Yuzuncu Yil University) ;
  • Ozler, Ali (Department of Obstetrics and Gynecology, School of Medicine, Dicle University) ;
  • Yuce, Kunter (Department of Obstetrics and Gynecology, Hacettepe University, School of Medicine) ;
  • Ulker, Volkan (Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Teaching and Research Hospital) ;
  • Arvas, Macit (Department of Obstetrics and Gynecology, School of Medicine, Cerrahpasa University) ;
  • Demirkiran, Fuat (Department of Obstetrics and Gynecology, School of Medicine, Cerrahpasa University) ;
  • Bese, Tugan (Department of Obstetrics and Gynecology, School of Medicine, Cerrahpasa University) ;
  • Tokgozoglu, Nedim (Department of Obstetrics and Gynecology, School of Medicine, Cerrahpasa University) ;
  • Onan, Anil (Department of Obstetrics and Gynecology, School of Medicine, Gazi University) ;
  • Sanci, Muzaffer (Department of Obstetrics and Gynecology, Ege Gynecology and Maternity Training and Research Hospital) ;
  • Gokcu, Mehmet (Department of Obstetrics and Gynecology, Ege Gynecology and Maternity Training and Research Hospital) ;
  • Tosun, Gokhan (Department of Obstetrics and Gynecology, Ege Gynecology and Maternity Training and Research Hospital) ;
  • Dikmen, Yilmaz (Department of Obstetrics and Gynecology, School of Medicine, Ege University) ;
  • Ozsaran, Aydin (Department of Obstetrics and Gynecology, School of Medicine, Ege University) ;
  • Terek, Mustafa Cosan (Department of Obstetrics and Gynecology, School of Medicine, Ege University) ;
  • Akman, Levent (Department of Obstetrics and Gynecology, School of Medicine, Ege University) ;
  • Yetimalar, Hakan (Department of Obstetrics and Gynecology, Izmir Ataturk Training and Research Hospital) ;
  • Kilic, Derya Sakarya (Department of Obstetrics and Gynecology, Izmir Ataturk Training and Research Hospital) ;
  • Gungor, Tayfun (Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Ozgu, Emre (Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Yildiz, Yunus (Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Kokcu, Arif (Department of Obstetrics and Gynecology, School of Medicine, Ondokuz Mayis University) ;
  • Kefeli, Mehmet (Department of Obstetrics and Gynecology, School of Medicine, Ondokuz Mayis University) ;
  • Kuruoglu, Serkan (Department of Obstetrics and Gynecology, School of Medicine, Ondokuz Mayis University) ;
  • Yuksel, Hasan (Department of Obstetrics and Gynecology, School of Medicine, Adnan Menderes University) ;
  • Guvenal, Tevfik (Department of Obstetrics and Gynecology, School of Medicine, Celal Bayar University) ;
  • Hasdemir, Pinar Solmaz (Department of Obstetrics and Gynecology, School of Medicine, Celal Bayar University) ;
  • Ozcelik, Bulent (Department of Obstetrics and Gynecology, School of Medicine, Erciyes University) ;
  • Serin, Serdar (Department of Obstetrics and Gynecology, School of Medicine, Erciyes University) ;
  • Dolanbay, Mehmet (Department of Obstetrics and Gynecology, School of Medicine, Erciyes University) ;
  • Arioz, Dagistan Tolga ;
  • Tuncer, Nadire (Department of Obstetrics and Gynecology, School of Medicine, Afyon Kocatepe University) ;
  • Bozkaya, Hasan (Department of Obstetrics and Gynecology, School of Medicine, Karadeniz Technical University) ;
  • Guven, Suleyman (Department of Obstetrics and Gynecology, School of Medicine, Karadeniz Technical University) ;
  • Kulaksiz, Deniz (Department of Obstetrics and Gynecology, School of Medicine, Karadeniz Technical University) ;
  • Varol, Fusun (Department of Obstetrics and Gynecology, School of Medicine, Trakya University) ;
  • Ali, Yanik (Department of Obstetrics and Gynecology, School of Medicine, Cumhuriyet University) ;
  • Ogurlu, Gonca (Department of Obstetrics and Gynecology, School of Medicine, Cumhuriyet University) ;
  • Simsek, Tayyup (Department of Obstetrics and Gynecology, School of Medicine, Akdeniz University) ;
  • Toptas, Tayfun (Department of Obstetrics and Gynecology, School of Medicine, Akdeniz University) ;
  • Dogan, Selen (Department of Obstetrics and Gynecology, School of Medicine, Akdeniz University) ;
  • Camuzoglu, Hakan (Department of Obstetrics and Gynecology, School of Medicine, Harran University) ;
  • Api, Murat (Department of Obstetrics and Gynecology, Research and Training Hospital, Zeynep Kamil Maternity and Pediatric) ;
  • Guzin, Kadir (Department of Obstetrics and Gynecology, Goztepe Training and Research Hospital, Istanbul Medeniyet University) ;
  • Eray, Caliskan (Department of Obstetrics and Gynecology, School of Medicine, Kocaeli University) ;
  • Doger, Emek (Department of Obstetrics and Gynecology, School of Medicine, Kocaeli University)
  • Published : 2014.04.30

Abstract

Background: To evaluate the incidence, diagnosis and management of GTN among 28 centers in Turkey. Materials and Methods: A retrospective study was designed to include GTN patients attending 28 centers in the 10-year period between January 2003 and May 2013. Demographical characteristics of the patients, histopathological diagnosis, the International Federation of Gynecology and Obstetrics (FIGO) anatomical and prognostic scores, use of single-agent and multi-agent chemotherapy, surgical interventions and prognosis were evaluated. Results: From 2003-2013, there were 1,173,235 deliveries and 456 GTN cases at the 28 centers. The incidence was calculated to be 0.38 per 1,000 deliveries. According to the evaluated data of 364 patients, the median age at diagnosis was 31 years (range, 15-59 years). A histopathological diagnosis was present for 45.1% of the patients, and invasive mole, choriocarcinoma and PSTTs were diagnosed in 22.3% (n=81), 18.1% (n=66) and 4.7% (n=17) of the patients, respectively. Regarding final prognosis, 352 (96.7%) of the patients had remission, and 7 (1.9%) had persistence, whereas the disease was mortal for 5 (1.4%) of the patients. Conclusions: Because of the differences between countries, it is important to provide national registration systems and special clinics for the accurate diagnosis and treatment of GTN.

References

  1. Ozalp SS, Oge T (2013). Gestational trophoblastic diseases in Turkey. J Reprod Med, 58, 67-71.
  2. May T, Goldstein DP, Berkowitz RS (2011). Current chemotherapeutic management of patients with gestational trophoblastic neoplasia. Chemother Res Pract, 2011, 806256.
  3. Oranratanaphan S, Lertkhachonsuk R (2014). Treatment of extremely high risk and resistant gestational trophoblastic neoplasia patients in king chulalongkorn memorial hospital. Asian Pac J Cancer Prev, 15, 925-8. https://doi.org/10.7314/APJCP.2014.15.2.925
  4. Ozalp SS, Yalçin OT, Tanir HM (2001). A hospital-based multicentric study results on gestational trophoblastic disease management status in a developing country. Eur J Gynaecol Oncol, 22, 221-2.
  5. Pongsaranantakul S, Kietpeerakool C (2009). Hysterectomy in gestational trophoblastic neoplasia: Chiang Mai university hospital's experience. Asian Pac J Cancer Prev, 10, 311-4.
  6. Turan T, Karacay O, Tulunay G, et al (2006). Results with EMA/CO (etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine) chemotherapy in gestational trophoblastic neoplasia. Int J Gynecol Cancer, 16, 1432-8. https://doi.org/10.1111/j.1525-1438.2006.00606.x
  7. Kurdoglu M, Kurdoglu Z, Kucukaydin Z, Sahin HG, Kamaci M (2011). Gestational trophoblastic diseases: Fourteen year experience of our clinic. J Turk Soc Obstet Gynecol, 8, 134-9. https://doi.org/10.5505/tjod.2011.98470
  8. Lurain JR (2011). Gestational trophoblastic disease II:classification and management of gestational trophoblastic neoplasia. Am J Obstet Gynecol, 204, 11-8. https://doi.org/10.1016/j.ajog.2010.06.072
  9. Manopunya M, Suprasert P (2012). Resistant gestational trophoblastic neoplasia patients treated with 5-fluorouracil plus actinomycin D. Asian Pac J Cancer Prev, 13, 387-90. https://doi.org/10.7314/APJCP.2012.13.1.387
  10. Alazzam M, Tidy J, Hancock BW, Osborne R, Lawrie TA (2012). First-line chemotherapy in low-risk gestational trophoblastic neoplasia. Cochrane Database Syst Rev, 7, 7102.
  11. Aydiner A, Keskin S, Berkman S, et al (2012). The roles of surgery and EMA/CO chemotherapy regimen in primary refractory and non-refractory gestational trophoblastic neoplasia. J Cancer Res Clin Oncol, 138, 971-7. https://doi.org/10.1007/s00432-012-1173-7
  12. Berkowitz RS, Goldstein DP (1996). Chorionic tumors. N Engl J Med, 335, 1740-8. https://doi.org/10.1056/NEJM199612053352306
  13. Berkowitz RS, Goldstein DP (2009). Current management of gestational trophoblasticdiseases. Gynecol Oncol, 112, 654-62. https://doi.org/10.1016/j.ygyno.2008.09.005
  14. Deng L, Yan X, Zhang J, Wu T (2009). Combination chemotherapy for high-risk gestational trophoblastic tumour. Cochrane Database Syst Rev, 2, 5196.
  15. Gul T, Yilmaztürk A, Erden AC (1997). A review of trophoblastic diseases at the medical school of Dicle University. Eur J Obstet Gynecol Reprod Biol, 74, 37-40. https://doi.org/10.1016/S0301-2115(97)00071-7
  16. Harma M, Harma M, Yurtseven S, Gungen N (2005). Gestational trophoblastic disease in Sanliurfa, southeast Anatolia, Turkey. Eur J Gynaecol Oncol, 26, 306-8.
  17. Kingdon SJ, Coleman RE, Ellis L, Hancock BW (2012). Deaths from gestational trophoblastic neoplasia: any lessons to be learned? J Reprod Med, 57, 293-6.

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