Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr;64(4):284-290.
doi: 10.3349/ymj.2022.0241.

Clinical Features of Gestational Trophoblastic Disease in Aged Women in South Vietnam

Bac Quang Nguyen  1 , Tuan Minh Vo  2 , Van Thi Thuy Phan  3 , Christopher Nguyen  3 , Hoang Vu  4 , Brian Vo  5
Affiliations

Clinical Features of Gestational Trophoblastic Disease in Aged Women in South Vietnam

Bac Quang Nguyen et al. Yonsei Med J. 2023 Apr.

Abstract

Purpose: This study aimed to determine the occurrence rate of gestational trophoblastic neoplasia (GTN) and its related factors in aged women with hydatidiform mole (HM) in Tu Du Hospital, Vietnam.

Materials and methods: This retrospective cohort study included 372 women aged ≥40 years with HM diagnosed through post-abortion histopathological assessment in Tu Du Hospital from January 2016 to March 2019. Survival analysis was used for GTN cumulative rate estimation, log-rank test for group comparison, and Cox regression model for determining GTN-related factors.

Results: After a 2-year follow-up, 123 patients were found to have GTN at a rate of 33.06% [95% confidence interval (CI): 28.30-38.10]. GTN occurrence meant that the time was 4.15±2.93 weeks with peaks at week 2 and 3 after curettage abortion. The GTN rate was remarkably higher in the ≥46-year age group than in the 40-to-45-year age group [hazard ratio (HR)=1.63; 95%CI: 1.09-2.44], as was the vaginal bleeding group compared to the non-bleeding group (HR=1.85; 95%CI: 1.16-2.96). Preventive hysterectomy and preventive chemotherapy plus hysterectomy in the intervention group reduced the GTN risk compared to the no intervention group at HRs of 0.16 (95%CI: 0.09-0.30) and 0.09 (95%CI: 0.04-0.21), respectively. Chemoprophylaxis failed to decrease the GTN risk when comparing the two groups.

Conclusion: Post-molar pregnancy GTN rate in aged patients was 33.06%, much higher than that of the general population. Preventive hysterectomy or chemoprophylaxis plus hysterectomy are effective treatment methods to support GTN risk reduction.

Keywords: Chemoprophylaxis; gestational trophoblastic neoplasia; hydatidiform mole; preventive hysterectomy.

PubMed Disclaimer

Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Gestational trophoblastic neoplasia rate over time (by week).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Berkowitz RS, Goldstein DP. In: Berek & Novak’s gynecology essentials. 16th ed. Berek JS, editor. Philadelphia, PA: Lippincott Williams & Wilkins; 2020. Gestational trophoblastic disease; pp. 2756–2794.
    1. Berkowitz RS, Goldstein DP. Clinical practice. Molar pregnancy. N Engl J Med. 2009;360:1639–1645. - PubMed
    1. Bouchard-Fortier G, Covens A. In: Comprehensive gynecology. 7th ed. Lobo RA, Gershenson DM, Lentz GM, Valea FA, editors. Amsterdam: Elsevier; 2017. Gestational trophoblastic disease; pp. 787–800.
    1. Altieri A, Franceschi S, Ferlay J, Smith J, La Vecchia C. Epidemiology and aetiology of gestational trophoblastic diseases. Lancet Oncol. 2003;4:670–678. - PubMed
    1. Sun R, Zhang Y, Zheng W, Tian Q, An R, Xue Y. Clinical characteristics of gestational trophoblastic neoplasia: a 15-year hospital-based study. Int J Gynecol Cancer. 2016;26:216–221. - PubMed