Document Detail

Gestational trophoblastic disease: is intensive follow up essential in all women?
MedLine Citation:
PMID:  15663134     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine the timescale of the registration process for gestational trophoblastic disease and its impact on hCG level at registration and subsequent need for chemotherapy. DESIGN: A prospective observational study using a standardised protocol for registration, assessment and treatment for molar pregnancy. SETTING: A supra-regional tertiary referral centre for gestational trophoblastic disease. PARTICIPANTS: A total of 2046 consecutive women registered between January 1994 and December 1998 with a diagnosis of molar pregnancy. METHODS: Data at and after registration, collected prospectively on a computerised database, were statistically analysed (by multiple logistic regression and ANOVA). MAIN OUTCOME MEASURES: Relationship between length of time to and hCG value at registration; also the subsequent need for chemotherapy. RESULTS: A total of 2046 women with a diagnosis of molar pregnancy were registered in the study period. The mean time interval between first evacuation and registration at the referral centre was 47 days (median 37, range 0-594). One hundred and five out of 2046 (5.1%) women needed chemotherapy. Sixty-three precent of the women (1296 out of 2046) had a normal level of urinary hCG (less than 40 IU/24 hours) at the time of registration and only one (0.08%) needed chemotherapy. Binary logistic regression analysis showed a statistically significant relationship between time to registration, hCG value, histology, pretreatment risk score and decision to administer chemotherapy. CONCLUSION: Women with gestational trophoblastic disease who were registered late were significantly more likely to have normal levels of hCG and were less likely to need chemotherapy. A less intensive follow up may be justified in women with gestational trophoblastic disease who are registered with a normal hCG level.
Narendra Pisal; John Tidy; Barry Hancock
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  111     ISSN:  1470-0328     ISO Abbreviation:  BJOG     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2005-01-24     Completed Date:  2005-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  1449-51     Citation Subset:  AIM; IM    
Department of Women's Health, Whittington Hospital, London, UK.
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MeSH Terms
Analysis of Variance
Antineoplastic Agents / therapeutic use*
Chorionic Gonadotropin / urine*
Follow-Up Studies
Hydatidiform Mole / drug therapy*,  urine
Prospective Studies
Regression Analysis
Time Factors
Reg. No./Substance:
0/Antineoplastic Agents; 0/Chorionic Gonadotropin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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