Abstract

OBJECTIVE
To evaluate the clinical outcomes in adolescents with gestational trophoblastic neoplasia (GTN) compared to adult women.
STUDY DESIGN
Patients with International Federation of Gynecology and Obstetrics criteria for GTN who underwent treatment between January 1, 1973, and December 31, 2010, were identified from the Donald P. Goldstein, M.D., Trophoblastic Tumor Registry of the New England Trophoblastic Disease Center. Adolescents included patients <20 years old at the time of diagnosis. Standard univariate analyses were performed, as were multivariate analyses with logistic regression to control for potential confounding variables.
RESULTS
We identified 423 women with GTN; 50 (12%) patients were adolescents (<20 years old), and 373 (88%) were > or = 20 years old. Both groups had the same rate of low-risk GTN score (98% vs. 98%, p = 0.9). In the adolescent group 47 (94%) women had stage I GTN, and 3 (6%) had stage III. In the adult group 304 (81.5%) women had stage I GTN, 4 (1%) had stage II, 64 (17%) had stage III and only 1 (0.5%) had stage IV disease (p = 0.7). Adolescents at molar presentation had higher rates of anemia (30% vs. 14%, p = 0.001), vaginal bleeding (86% vs. 67%, p = 0.001), and a uterus with size greater than dates (42% vs. 24%, p = 0.007). Factors determined to significantly influence resistance to initial chemotherapeutic treatment on multivariate analysis were beta-hCG level at molar presentation > 100,000 mIU/mL, beta-hCG level at persistence >20,000 mIU/mL, the presence of metastasis, and duration of disease > 4 months. Age <20 years old was not a prognostic factor of resistance to initial chemotherapeutic treatment.
CONCLUSION
There was no difference between adolescents and adult women in the rates of low-risk GTN, stage of GTN, and the frequency of resistance to initial chemotherapeutic treatment.

Authors

Rauh-Hain JA, Growdon WB, Braga A, Goldstein DP, Berkowitz RS

Institution

Division of Gynecologic Oncology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.

Source

The Journal of reproductive medicine 57:5-6 pg 237-42

MeSH

Adolescent
Adult
Age Factors
Anemia
Chorionic Gonadotropin, beta Subunit, Human
Drug Resistance, Neoplasm
Female
Gestational Trophoblastic Disease
Humans
Neoplasm Staging
Pregnancy
Treatment Outcome
Uterine Hemorrhage
Uterus

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22696819