Curative effect of second curettage for treatment of gestational trophoblastic disease - Results of the Belgian registry for gestational trophoblastic disease.

Vandewal, Aleide;Delbecque, Katty;Van Rompuy, Anne-Sophie;Noel, Jean-Christophe;Han, Silenyy N;et.al.
(2021) European Journal of Obstetrics & Gynecology and Reproductive Biology — Vol. 257, n° 1, p. 95-99 (2021)

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Authors
  • Vandewal, Aleide
    Author
  • Delbecque, Katty
    Author
  • Van Rompuy, Anne-Sophie
    Author
  • Noel, Jean-Christophe
    Author
  • Marbaix, EtienneUCLouvain
    Author
  • Han, Silenyy N
    Author
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Abstract
(en) OBJECTIVE: We assessed the curative effect of a second curettage in patients with persistent hCG serum levels after first curettage for a gestational trophoblastic disease (GTD). STUDY DESIGN: This prospective observational study used the data of the Belgian register for GTD between July 2012 and January 2017. We analysed the data of patients who underwent a second curettage. We included 313 patients in the database. Primary endpoints were need for second curettage and chemotherapy. RESULTS: Thirty-seven patients of the study population (12 %) underwent a second curettage. 20 had persistent human chorionic gonadotropin hormone (hCG) elevation before second curettage. Of them, 9 patients (45 %) needed no further treatment afterwards. Eleven patients (55 %) needed further chemotherapy. Nine (82 %) were cured with single-agent chemotherapy and 2 patients (18 %) needed multi-agent chemotherapy. Of the 37 patients, patients with hCG levels below 5000 IU/L undergoing a second curettage were cured without chemotherapy in 65 % versus 45 % of patients with hCG level more than 5000 IU/L. Of the ten patients with a hCG level below 1000 IU/L, eight were cured without chemotherapy. CONCLUSIONS: Patients with post-mole gestational trophoblastic neoplasia can benefit from a second curettage to avoid chemotherapy, especially when the hCG level is lower than 5000 IU/L.
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Vandewal, A., Delbecque, K., Van Rompuy, A.-S., Noel, J.-C., Marbaix, E., Delvenne, P., Nisolle, M., Van Nieuwenhuysen, E., Kridelka, F., Vergote, I., Goffin, F., & Han, S. N. (2021). Curative effect of second curettage for treatment of gestational trophoblastic disease - Results of the Belgian registry for gestational trophoblastic disease. European Journal of Obstetrics & Gynecology and Reproductive Biology, 257(1), 95-99. https://doi.org/10.1016/j.ejogrb.2020.12.001 (Original work published 2021)