The impact of uterine re-curettage, pre-evacuation and week-one level of hCG on the number of chemotherapy courses in treatment of post molar GTN
Reda A Hemida, Eman Toson and H.C. Van Doorn
Background: Post molar GTN was reported to occur in 7.5-20% of patients following evacuation of complete hydatidiform moles and in 2.5-7.5% following evacuation of partial moles. The role of uterine re-curettage in post molar GTN is not clear.
Objectives: Study of the correlation of pre-evacuation and week- one level of hCG, and uterine re-curettage to the number of chemotherapy courses in treatment of post molar GTN.
Patients and methods: This retrospective study included 29 cases of post molar GTN through reviewing their medical records.
Results: There were 25 cases (86.21) of low risk, and 4 cases of high risk score (13.79%). The 3 year survival was 96.6%. There were non-significant correlation of age, parity, pre-evacuation level and hCG in week-1 to number of chemotherapy courses, while uterine recurettage was significantly correlated to number of chemotherapy courses (p=0.04).
Conclusion: Uterine re-curettage was significantly correlated to less number of chemotherapy courses in patients with post molar GTN (p=0.04). Pre-evacuation and week-1 hCG were not correlated to number of chemotherapy cycles. A large prospective randomized trial to clarify the beneficial effect of uterine re-curettage is recommended.
Keywords: Gestational trophoblastic neoplasia; hCG; re-curettage