Braga Antonio, Uberti Elza Maria Hartmann, Fajardo Maria do Carmo, Viggiano Maurício, Sun Sue Yazaki, Grillo Bruno Maurizio, Padilha Sérgio Lunardon, de Andrade Jurandyr Moreira, de Souza Christiani Bisinoto, Madi José Mauro, Maestá Izildinha, Silveira Eduardo
J Reprod Med. 2014 May-Jun;59(5-6):241-7.
To evaluate treatment of Brazilian patients with gestational trophoblastic disease (GTD).
A retrospective cohort study with analysis of medical reports performed in 10 Brazilian referral centers from January 2000 to December 2011.
Of 5,250 patients 3 died (0.06%) at the time of uterine evacuation. Spontaneous remission of GTD (group G1) was observed in 4,103 cases, and 1,144 (21.8%) progressed to gestational trophoblastic neoplasia (GTN) (G2). In G1 2,716 (66.2%) had complete hydatidiform mole (HM) and 1,210, partial HM (29.5%); 3,772 patients (92.7%) recovered as noted in December 2012. In G2, of 1,118 patients treated, initial histopathological results of previous gestation were complete HM (77.5% [n = 886]), partial HM (8.8% [n = 100]), and choriocarcinoma (8.0% [n = 92]); 930 (81.3%) were low-risk, 200 (17.5%) were high-risk GTN, and 14 had placental site trophoblastic tumor (PSTT) (1.2%); cure was achieved in 1,078 cases (96.4%), but 26 patients (2.3%) died (4 low-risk [0.4%], 19 high-risk [9.5%], and 3 PSTT [21.4%]).
The highest death rates were due to high-risk GTN and PSTT. Patients with molar pregnancy should be referred to a referral center for an early diagnosis and prompt treatment of GTN in order to reduce the morbidity and mortality found in advanced stages.
评估巴西妊娠滋养细胞疾病（GTD）患者的治疗情况。
一项回顾性队列研究，分析了2000年1月至2011年12月期间在巴西10个转诊中心的医疗报告。
5250例患者中，3例（0.06%）在子宫排空时死亡。4103例患者出现GTD自发缓解（G1组），1144例（21.8%）进展为妊娠滋养细胞肿瘤（GTN）（G2组）。G1组中，2716例（66.2%）为完全性葡萄胎（HM），1210例为部分性HM（29.5%）；截至2012年12月，3772例患者（92.7%）康复。G2组中，1118例接受治疗的患者，既往妊娠的初始组织病理学结果为完全性HM（77.5% [n = 886]）、部分性HM（8.8% [n = 100]）和绒毛膜癌（8.0% [n = 92]）；930例（81.3%）为低危GTN，200例（17.5%）为高危GTN，14例为胎盘部位滋养细胞肿瘤（PSTT）（1.2%）；1078例患者（96.4%）治愈，但26例患者（2.3%）死亡（4例低危[0.4%]、19例高危[9.5%]和3例PSTT[21.4%]）。
最高死亡率归因于高危GTN和PSTT。葡萄胎妊娠患者应转诊至转诊中心，以便早期诊断并及时治疗GTN，从而降低晚期出现的发病率和死亡率。
