Epidemiological Report on the Treatment of Patients with Gestational Trophoblastic Disease in 10 Brazilian Referral Centers Results After 12 Years Since International FIGO 2000 Consensus

OBJECTIVE: To evaluate treatment of Brazilian patients with gestational trophoblastic disease (GTD).STUDY DESIGN: A retrospective cohort study with analysis of medical reports performed in 10 Brazilian referral centers from January 2000 to December 2011.RESULTS: Of 5,250 patients 3 died (0.06%) at the time of uterine evacuation. Spontaneous remission of GTD (group G1) was observed in 4,103 cases, and 1,144 (21.8%) progressed to gestational trophoblastic neoplasia (GTN) (G2). In G1 2,716 (66.2%) had complete hydatidiform mole (HM) and 1,210, partial HM (29.5%); 3,772 patients (92.7%) recovered as noted in December 2012. In G2, of 1,118 patients treated, initial histopathological results of previous gestation were complete HM (77.5% [n = 886]), partial HM (8.8% [n = 100]), and choriocarcinoma (8.0% [n = 92]); 930 (81.3%) were low-risk, 200 (17.5%) were high-risk GTN, and 14 had placental site trophoblastic tumor (PSTT) (1.2%); cure was achieved in 1,078 cases (96.4%), but 26 patients (2.3%) died (4 low-risk [0.4%], 19 high-risk [9.5%], and 3 PSTT [21.4%]).CONCLUSION: The highest death rates were due to high-risk GTN and PSTT. Patients with molar pregnancy should be referred to a referral center for an early diagnosis and prompt treatment of GTN in order to reduce the morbidity and mortality found in advanced stages.Univ Fed Rio de Janeiro, Laranjeiras Matern Sch, Fluminense Fed Univ, Antonio Pedro Univ Hosp,Santa Casa Misericordia R, BR-21941 Rio De Janeiro, BrazilIrmandade Santa Casa Misericordia Porto Alegre Ma, Porto Alegre, RS, BrazilGoias Fed Univ, Clin Hosp, Goiania, Go, BrazilUniv Fed Sao Paulo, Sao Paulo Univ Hosp, Sao Paulo, BrazilParana Univ Hosp, Clin Hosp, Curitiba, Parana, BrazilUniv Sao Paulo, Clin Hosp Ribeirao Preto, BR-05508 Sao Paulo, BrazilCaxias do Sul Univ, Gen Hosp Caxias do Sul, Petropolis, RS, BrazilSao Paulo State Univ, Botucatu Med Sch, Botucatu, SP, BrazilGuilherme Alvaro Hosp Santos, Sao Paulo, BrazilUniv Fed Sao Paulo, Sao Paulo Univ Hosp, Sao Paulo, BrazilWeb of Scienc