Navegando por Palavras-chave "Gestational Trophoblastic Neoplasia"

Agora exibindo 1 - 1 de 1
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Perfil epidemiológico do centro de referência de doenças trofoblásticas do Hospital São Paulo - Universidade Federal de São Paulo - Escola Paulista de Medicina
    (Universidade Federal de São Paulo (UNIFESP), 2019-11-28) Pimenta, Bruna Sanches Ozane [UNIFESP]; Sun, Sue Yazaki [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: gestational trophoblastic disease (GTD) is a heterogeneous group of disorders including hydatidiform mole (HM) and gestational trophoblastic neoplasia (GTN) – malignant form that encompasses invasive mole, choriocarcinoma, placental site trophoblastic tumor and epithelioid trophoblastic tumor. The risk of a post-molar GTN is approximatelly 20% after complete mole (CM) and 5% in partial mole (PM). Reported incidence rates of HM show wide geographic and temporal variations. Objectives: the aim of this study was to create a database and to describe and analyse the epidemiological characteristics of patients with GTD treated at São Paulo Hospital gestational trophoblastic disease reference center (RC) within the last 30 years. Methods: review of the medical records of all patients with GTD that received care at the RC between 1990 and 2017. Data collected included: age, ethnicity, number of gestations, parity, gestacional age at molar evacuation, presence of vaginal bleeding, GTD type, molar evacuation at reference center (RC) or elsewhere (NRC), evolution for gestational trophoblastic neoplasia. Significance level was set at p <0.05. Results: a total of 747 medical records were studied resulting in 441 CM, 162 PM, 130 non-classified hydatidiform mole (NCM), 10 GTN without previous hydatidiform mole histopathologically confirmed and 4 twin pregnancy with CM and a normal fetus. Among 603 patients with CM and PM, 62% underwent uterine evacuation at our center, while 38% were referred center after evacuation at NRC. Among RC patients 74% had CM and 26% had PM and among NRC 72% had CM and 28% had PM. The mean age of patients with HM between the periods was higher in the last decade. PM distribution was preferentially from 19 to 40 year-old (yo) and CM at the age groups: < 19 yo and > 40 yo. Clinical symptoms were most frequent in CM, however, recurrence was most evident in PM. Among the HM cases that underwent evacuation at our center, postmolar GTN occurred in 12.3% of the patients with CM and in 7.1% of those with PM. Considering all GTN cases treated at our center, 74% (134/181) had pregnancy index treated in NRC and 26%(47/181) at our center. High-risk GTN cases according FIGO/WHO were mostly originated from NRC (NRC 13.6% - 18/132 x RC 4.3% - 2/47)(p=0,08). Conclusion: high-risk GTN were mostly originated from NRC what may be related to a delayed diagnosis, highlighting the importance of the reference center in improving the GTD treatment.