Clinical Characteristics of Malignant Gestational Trophoblastic Diseases in Srinagarind Hospital and Problems in Management

Abstract

There were 43 malignant GTD patients who were admitted to Srinagarind Hospital from March 1983 to October 1987. The incidence of the disease was 1 :329 patients (62.8%) had pathological diagnosis of  choriocarcinoma and of invasive mole in 22 cases (51.2%) and 5 cases (11.6%) respectively. 28 patients (65.1%) had metastatic disease. The majority of patients had chemotherapy alone. The remission rates of the patients in non-metastatic, low-risk metastatic and high-risk metastatic were 100 , 50 and 36.8% respectively.There were 16 deaths (37.2%) . Only 6 patients (20.7%) visited for follow up examination program completely. The major problems found in this study were the high mortality rate of the patients, the problem of urinary hCG level analysis and the large proportion of patients not attending the follow up program after treatment.