Influence of Hydatidiform Mole Follow-Up Setting on Postmolar Gestational Trophoblastic Neoplasia Outcomes A Cohort Study

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dc.contributor.authorSobral Dantas, Patricia Range
dc.contributor.authorMaestá, Izildinha [UNESP]
dc.contributor.authorCortes-Charry, Rafael
dc.contributor.authorGrowdon, Whitfield B.
dc.contributor.authorBraga, Antonio
dc.contributor.authorRudge, Marilza Vieira Cunha [UNESP]
dc.contributor.authorBerkowitz, Ross S.
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionUniversidade Central de Venezuela (UCV)
dc.contributor.institutionHarvard Univ
dc.contributor.institutionMassachusetts Gen Hosp
dc.date.accessioned2014-05-20T13:35:29Z
dc.date.available2014-05-20T13:35:29Z
dc.date.issued2012-07-01
dc.description.abstractOBJECTIVE: To assess the influence of hydatidiform mole (HM) management setting (reference center versus other institutions) on gestational trophoblastic neoplasia (GTN) outcomes. METHODS: This cohort study included 270 HM patients attending Botucatu Trophoblastic Diseases Center (BTDC, São Paulo State University, Brazil) between January 1.990 and December 2009 (204 undergoing evacuation and entire postmolar follow-up at BTDC and 66 from other institutions [OIs]). GTN characteristics and outcomes were analyzed and compared according to HM management setting. The confounding variables assessed included age, gravidity, parity, number of abortions and HM type (complete or partial). Postmolar GTN outcomes were compared using Mann-Whitney's test, chi(2) test or Fisher's exact test.RESULTS: Postmolar GTN occurred in 34 (34/204= 16.7%) BTDC patients and in 27 (27/66=40.9%) of those initially treated in other institutions. BTDC patients showed lower metastasis rate (5.8% vs. 48%, p = 0.003) and lower median FIGO (2002) score (2.00 0.00, 3.001 vs. 4.00 [2.00, 7.00], p = 0.003]. Multiagent chemotherapy to treat postmolar GTN was required in 2 BTDC cases (5.9%) and in 8 OI cases (29.6%) (p = 0.017). Median time interval between molar evacuation and chemotherapy onset was shorter among BTDC patients (7.0 [6.0, 10.0] vs. 10.0[7.0, 16.0], p = 0.040). CONCLUSION: BTDC patients showed GTN characteristics indicative of better prognosis. This underscores the importance of GTD specialist centers. (J Reprod Med 2012;57:305-309)en
dc.description.affiliationSão Paulo State Univ, Dept Gynecol & Obstet, Botucatu Med Sch, UNESP,Trophoblast Dis Ctr, BR-18618970 Botucatu, SP, Brazil
dc.description.affiliationCent Univ Venezuela, Hosp Univ Caracas, Dept Obstet & Gynecol, Caracas, Venezuela
dc.description.affiliationHarvard Univ, Brigham & Womens Hosp, Sch Med, Div Gynecol Oncol,Dept Obstet & Gynecol, Boston, MA 02115 USA
dc.description.affiliationMassachusetts Gen Hosp, Boston, MA 02114 USA
dc.description.affiliationUnespSão Paulo State Univ, Dept Gynecol & Obstet, Botucatu Med Sch, UNESP,Trophoblast Dis Ctr, BR-18618970 Botucatu, SP, Brazil
dc.format.extent305-309
dc.identifierhttp://www.reproductivemedicine.com/toc/auto_abstract.php?id=23983
dc.identifier.citationJournal of Reproductive Medicine. St Louis: Sci Printers & Publ Inc, v. 57, n. 7-8, p. 305-309, 2012.
dc.identifier.issn0024-7758
dc.identifier.lattes9012667997804219
dc.identifier.lattes6758680388835078
dc.identifier.orcid0000-0002-9227-832X
dc.identifier.urihttp://hdl.handle.net/11449/12211
dc.identifier.wosWOS:000306533400007
dc.language.isoeng
dc.publisherSci Printers & Publ Inc
dc.relation.ispartofJournal of Reproductive Medicine
dc.relation.ispartofjcr0.452
dc.relation.ispartofsjr0,270
dc.rights.accessRightsAcesso restrito
dc.sourceWeb of Science
dc.subjectgestational trophoblastic neoplasiaen
dc.subjecthydatidiform moleen
dc.subjectmanagement settingen
dc.titleInfluence of Hydatidiform Mole Follow-Up Setting on Postmolar Gestational Trophoblastic Neoplasia Outcomes A Cohort Studyen
dc.typeArtigo
dcterms.rightsHolderSci Printers & Publ Inc
unesp.author.lattes9012667997804219
unesp.author.lattes6758680388835078
unesp.author.orcid0000-0002-2942-6182[5]
unesp.author.orcid0000-0002-9227-832X[6]
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt

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