EP409/#892 Gestational trophoblastic neoplasia: a Tunisian retrospective study

Objectives

Gestational Trophoblastic neoplasia (GTN) are rare with good prognosis malignancies. We aimed in our study to evaluate clinico-pathological and therapeutic characteristics and outcomes of GTN in the Tunisian context.

Methods

We conducted a retrospective monocentric study including 29 Tunisian patients with GTN between January 2013 and May2022. Clinico- pathological Data, treatment and outcomes were collected from medical records.

Results

Patients were under 40 years old in 55% of cases. One patient (4%) presented hemorrhagic shock which was controlled by hysterectomy . Previous pregnancies were hydatiform mole , abortion and full term pregnancy in respectively 14%, 21% and 65%. Metastatic disease was reported in 38% of patients. Metastases occurred in lung in 34% of cases and brain in 4%. Choriocarcinoma was diagnosed in 24% of cases. Interval between index pregnancy and chemotherapy was under 4 months in 71.4% of cases. High risk disease (FIGO score ≥7) was reported in 39% of cases who received EMA-CO (etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine) regimen. All patients with low risk disease received methotrexate (MTX) regimen. Median number of cycles until normalization of HCG level was 5 cycles [2–12]. Consolidation courses were received in 55 % of cases. Reascension of HCG level was reported in 3 cases, 2 of them after MTX regimen. Salvage regimen were EMACO and BEP (Bleomycin, etoposide, and cisplatin). After a median follow up of 72 months [12–120], all patients were alive.

Conclusions

Epidemiological and clinical characteristics and therapeutic outcomes of our study population are concordant with literature.