Evolução da Doença Trofoblástica Gestacional em pacientes do Nordeste Brasileiro: Estudo de Coorte Prognóstica em um centro de referência

Abstract

INTRODUCTION: Gestational Trophiblastic Disease (GTD) is a low-grade tumor pathology that occurs in young women, and its adequate treatment can preserve the reproductive future of these patients. DTG is divided into two groups: hydatidiform mole and gestational trophoblastic neoplasia (NTG). About 20% of patients with GTD present evolution to malignant form, called Gestational Trofobastic Neoplasia (GTN). Factors intrinsic to the maternal and extrinsic organism; such as access to health care, may interfere with the prognosis of GFR. OBJECTIVE: To know the evolution of GFR in women diagnosed with Mola Hidatifome. METHODS: A retrospective, prognostic cohort study of active search in medical records of women with GTD followed at the reference center of the Climério de Oliveira Maternity, from January 2000 to December 2014. RESULTS: A total of 193 patients were found in the age group. Prevalence was between 20 and 30 years (49.2%). Only 2.1% of them had previous molar gestation. The evolution to NTG occurred in 36 patients (18.7%), two of whom had the initial histopathological diagnosis of invasive Mola. However, 45 patients (24.3%) abandoned follow-up before 12 months, of whom 14 had active disease. There was a death in the institution after molar emptying, probably due to trophoblastic embolism. CONCLUSION: The evolution of GTD in the women studied in this center of reference revealed that 18.7% of the patients evolved to GTN, an equivalent result to that reported in other centers in Brazil. However, we emphasise the patients who left the follow-up with active disease (7.3%), which may be underestimating the number of patients who progressed to GTN. This finding emphasizes the need for the interdisciplinary care and the active search for these patients, considering that the GTD, if untreated, can attend to maternal death.