| Popis: |
Background Gestational trophoblastic tumors (GTTs) are the malignant forms of gestational trophoblastic diseases. They always follow a pregnancy, most often molar. The diagnosis of TTG is based on an abnormal course of HCG (chorionic gonadotropin hormone) and / or signs of ultrasound invasion and/or histological confirmation. Methods it is a retrospective study of 29 cases of GTT collected at the medical oncology department of Hassan II University Hospital-Fez, over a period of 7 years from January 2010 to December 2016. Results The average age was 35 years old. Sixty-five percent (65%) of our patients were pauciparous. The causal pregnancy was in 83% of cases a molar pregnancy. The staging of patients revealed pulmonary metastases in 67% of cases, liver in 19% of cases, renal in 7% of cases and cerebral in 7% of cases. Nine patients (31 %) underwent hysterectomy, with postoperative chemotherapy for 8 patients. Fifty-two percent (52%) were at high risk while 48% were low risk. Low risk patients received methotrexate-based monochemotherapy, and HCG hormone became negative after an average of 6.5 cycles. High risk patients received a polychemotherapy with differents protocols used; EMA-CO, BEP, or Cisplatin-Etoposid-MTX protocol, after an average of 3.28 cycles, the HCG hormone became negative. Eighty-six percent of our patients benefited from clinical and biological monitoring. The evolution of our patients was marked by a complete clinical and biological remission in 89.65% of patients, after an average of 12 weeks. The median survival was 76.4 ± 2.7 months, after a median follow-up of 29.78 months. Conclusions Malignant gestational trophoblastic tumors are a rare and challenging disease with heavy psychosocial impact hat affect the young woman who has not only had a pregnancy loss but also may be faced with a life-threatening illness. More understanding of risk factors, carcinogenesis and management is required to improve the outcome of thes patients. larger studies are still needed. Legal entity responsible for the study The authors. Funding Has not received any funding. All authors have declared no conflicts of interest. |
