Department of Gynecology Oncology, Dalian Women's and Children's Medical Center (Group), Dalian, Liaoning, China.
Department of Pathology, Dalian Women's and Children's Medical Center (Group), Dalian, Liaoning, China.
Int J Gynecol Cancer. 2022 Feb;32(2):147-152. doi: 10.1136/ijgc-2021-002797. Epub 2021 Nov 19.
To assess the strategy and value of centralized surveillance of hydatidiform mole at a regional hospital in China and to investigate the necessity of prophylactic chemotherapy for high-risk complete hydatidiform mole.
Between February 2013 and February 2020, all women with hydatidiform mole in Dalian Women's and Children's Medical Center (Group) were registered for surveillance and treatment when indicated. Women with complete hydatidiform mole were categorized into low-risk and high-risk groups according to the criteria from Song Hongzhao's trophoblastic neoplasia. Outcomes and treatments were analyzed retrospectively.
In total, 703 women with hydatidiform mole were registered for surveillance with a follow-up rate of 97.9% (688/703). 680 women were enrolled and 52 (7.6%) developed post-molar gestational trophoblastic neoplasia, all with low-risk International Federation of Gynecology and Obstetrics (FIGO) scores 0-5. Post-molar gestational trophoblastic neoplasia was diagnosed in 12.3% (51/413) of patients with complete hydatidiform moles and 0.4% (1/263) of patients were diagnosed with partial hydatidiform moles (χ=32.415, p<0.001). Post-molar gestational trophoblastic neoplasia was diagnosed in 27.7% (28/101) of the high-risk complete hydatidiform mole group and in 7.4% (23/312) of the low-risk complete hydatidiform mole group (χ=29.196, p<0.001). No difference in the pre-treatment assessments of patients with post-molar gestational trophoblastic neoplasia was found between the low-risk and high-risk complete hydatidiform mole groups (all p>0.05). All 52 patients with post-molar gestational trophoblastic neoplasia were cured, with a complete response rate of 61.2% (30/49) with first-line single-agent chemotherapy.
A centralized hydatidiform mole surveillance program is feasible and effective and may improve the prognosis of patients with post-molar gestational trophoblastic neoplasia. Prophylactic chemotherapy is not recommended for women with high-risk complete hydatidiform mole with adequate surveillance.
评估中国某区域医院对葡萄胎进行集中监测的策略和价值，并探讨高危完全性葡萄胎预防性化疗的必要性。
2013 年 2 月至 2020 年 2 月，大连妇女儿童医疗中心（集团）对所有葡萄胎患者进行登记监测和必要的治疗。根据 Song Hongzhao 的滋养细胞肿瘤标准，将完全性葡萄胎患者分为低危组和高危组。回顾性分析患者的结局和治疗情况。
共登记 703 例葡萄胎患者进行监测，随访率为 97.9%（688/703）。共入组 680 例患者，其中 52 例（7.6%）发生葡萄胎后妊娠滋养细胞肿瘤，所有患者国际妇产科联盟（FIGO）评分均为 0-5 分，低危。完全性葡萄胎中，51/413（12.3%）患者诊断为葡萄胎后妊娠滋养细胞肿瘤，263 例部分性葡萄胎中 1/263（0.4%）患者诊断为葡萄胎后妊娠滋养细胞肿瘤（χ=32.415，p<0.001）。高危完全性葡萄胎组中 28/101（27.7%）患者诊断为葡萄胎后妊娠滋养细胞肿瘤，低危完全性葡萄胎组中 23/312（7.4%）患者诊断为葡萄胎后妊娠滋养细胞肿瘤（χ=29.196，p<0.001）。葡萄胎后妊娠滋养细胞肿瘤低危和高危完全性葡萄胎组患者治疗前评估无差异（均 p>0.05）。52 例葡萄胎后妊娠滋养细胞肿瘤患者均治愈，一线单药化疗完全缓解率为 61.2%（30/49）。
葡萄胎集中监测方案是可行和有效的，可能改善葡萄胎后妊娠滋养细胞肿瘤患者的预后。高危完全性葡萄胎患者无需预防性化疗，充分监测即可。
