Effect of race/ethnicity on clinical presentation and risk of gestational trophoblastic neoplasia in patients with complete and partial molar pregnancy at a tertiary care referral center

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dc.contributor.authorGockley, Allison A.
dc.contributor.authorJoseph, Naima T.
dc.contributor.authorMelamed, Alexander
dc.contributor.authorSun, Sue Yazaki [UNIFESP]
dc.contributor.authorGoodwin, Benjamin
dc.contributor.authorBernstein, Marilyn
dc.contributor.authorGoldstein, Donald P.
dc.contributor.authorBerkowitz, Ross S.
dc.contributor.authorHorowitz, Neil S.
dc.date.accessioned2019-07-22T15:46:44Z
dc.date.available2019-07-22T15:46:44Z
dc.date.issued2016
dc.description.abstractBACKGROUND: The reported incidence of molar pregnancy varies widely among different geographic locations. This variation has been attributed, at least in part, to racial/ethnic differences. While the incidence of molar pregnancies is decreasing, certain ethnic groups such as Hispanics, Asians, and American Indians continue to have an increased risk of developing gestational trophoblastic disease across the globe. OBJECTIVE: We sought to describe the potential effect of ethnicity/race on the presentation and clinical course of complete mole and partial mole. STUDY DESIGN: All patients followed up for complete mole and partial mole at a single institution referral center from 1994 through 2013 were identified. Variables including age, race, gravidity, parity, gestational age, presenting signs/symptoms, serum human chorionic gonadotropin values, and development of gestational trophoblastic neoplasia were extracted from medical records and patient surveys. Patients with complete mole and partial mole were categorized into race/ethnicity groups defined as white, black, Asian, or Hispanic. Due to low numbers of non-white patients with partial mole in each non-white category, patients with partial mole were grouped as white or non-white. Continuous variables were compared using the Kruskal-Wallis test and binary variables were compared using the Fisher exact test. RESULTS: A total of 167 complete mole patients with known race/ethnicity status were included (57.48% white, 14.97% Asian, 14.37% black, 13.17% Hispanic). Hispanics presented at younger age (median 24.5 years) compared to whites (median 32.0 years, P = .04) and Asians median 31.0 years, P = .03). Blacks had higher gravidity than whites (P < .001) and Hispanics (P = .05). There was no significant difference in presenting symptoms, gestational age at diagnosis, and preevacuation serum human chorionic gonadotropin level by race/ethnicity. Hispanics were significantly less likely than whites to develop gestational trophoblastic neoplasia (absolute risk difference, 28.6%en
dc.description.abstract95% confidence interval, 8.1-39.2%en
dc.description.abstractP = .02). A total of 144 patients with partial mole were analyzed. There were 108 white and 36 non-white patients. Median age was 31 years for white and 29 years for non-white patients (P = .006). Median gravidity was 2 for white and 3 for non-white patients (P < .001), and median parity was 0 for white patients and 1 for non-white patients (P = .003). There were no significant differences with respect to presenting signs and symptoms, gestational age, preevacuation human chorionic gonadotropin level, or risk of progression to gestational trophoblastic neoplasia. CONCLUSION: Hispanic patients with complete molar pregnancy had a significantly lower risk of developing gestational trophoblastic neoplasia than white patients. There were no significant differences among groups in terms of presenting symptoms, gestational age at diagnosis, or preevacuation human chorionic gonadotropin levels for either complete mole or partial mole patients.en
dc.description.affiliationBrigham & Womens Hosp, Dept Obstet & Gynecol, Div Gynecol Oncol, 75 Francis St, Boston, MA 02115 USA
dc.description.affiliationMassachusetts Gen Hosp, Vincent Dept Obstet Gynecol & Reprod Biol, Boston, MA USA
dc.description.affiliationHarvard Med Sch, Dept Obstet Gynecol & Reprod Biol, Boston, MA USA
dc.description.affiliationHarvard Canc Ctr, Dana Farber Canc Inst, Susan F Smith Ctr Womens Canc, Gynecol Oncol Program, Boston, MA USA
dc.description.affiliationDonald P Goldstein MD Trophoblast Tumor Registry, New England Trophoblast Dis Ctr, Boston, MA USA
dc.description.affiliationUniv Fed Sao Paulo, Paulista Sch Med, Sao Paulo Hosp, Dept Obstet, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Paulista Sch Med, Sao Paulo Hosp, Trophoblast Dis Ctr, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Paulista Sch Med, Sao Paulo Hosp, Dept Obstet, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Paulista Sch Med, Sao Paulo Hosp, Trophoblast Dis Ctr, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent-
dc.identifierhttp://dx.doi.org/10.1016/j.ajog.2016.04.019
dc.identifier.citationAmerican Journal Of Obstetrics And Gynecology. New York, v. 215, n. 3, p. -, 2016.
dc.identifier.doi10.1016/j.ajog.2016.04.019
dc.identifier.issn0002-9378
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/51052
dc.identifier.wosWOS:000382495100025
dc.language.isoeng
dc.publisherMosby-Elsevier
dc.relation.ispartof18th World Congress on Gestational Trophoblastic Diseases
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectethnicityen
dc.subjectgestational trophoblastic neoplasiaen
dc.subjectmolar pregnancyen
dc.subjectraceen
dc.titleEffect of race/ethnicity on clinical presentation and risk of gestational trophoblastic neoplasia in patients with complete and partial molar pregnancy at a tertiary care referral centeren
dc.typeinfo:eu-repo/semantics/article
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