Gestational trophoblastic diseases in the Philippines /
Cagayan, Ma Stephanie Fay S.
Gestational trophoblastic diseases in the Philippines / Ma Stephanie Fay S. Cagayan
Objectives: To describe the Philippine hospital-based prevalence rate of gestational trophoblastic disease (GTD) and to discuss changes in the management of GTD over the past decades. Study Design: A retrospective descriptive study was done with the following as sources of data: published report on the national incidence of GTD from 1977-1984 and its management, the Philippine Obstetrical and Gynecological Society (POGS)- Committee on Nationwide Statistics Reports 1985-1994, the 1997-2001 POGS Annual Reports on Diseases and Procedures, the 1997-2001 POGS Trophoblastic Disease Registry, the 1991-2001 University of the Philippines-Philippine General Hospital (UP-PGH) Trophoblastic Disease Registry and Annual Reports and the 1991-2001 UP-PGH Dept. of Obstetrics and Gynecology Annual Reports on Diseases and Procedures. Results: The prevalence rate of hydatidiform mole dropped from 7/1000 pregnancies in the early 80's to 2.7/1000 pregnancies from 1985-1994 with note of increase to 3.5/1000 in 1997-2001. At the UP-PGH the prevalence rate of hydatidiform mole is 13.96. This is because the hospital is a known tertiary referral center for GTDs. The national prevalence rate of choriocarcinomas and other trophoblastic neoplasias (GTN) has remained almost constant at 0.55 and 0.52 per 1000 pregnancies respectively from 1990-1994 and 1997-2001. Again, PGH showed a high prevalence for choriocarcinoma and other GTN at 8/1000 pregnancies. Because patients with GTD are invariably indigent, modifications on standard treatment practices have been adapted to bring down the cost of chemotherapy without sacrificing survival and remission rates such as outpatient treatment with methotrexate as chemoprophylaxis and treatment for low risk GTN and use of modified EMA-CO for high risk GTN. Surgery has been widely used as an adjunct to treatment. Conclusion: Despite advances in diagnosis and management of GTD, GTD remains a disease to reckon with in the country. Reasons for poor outcome such as poor patient compliance, inadequate/poor quality of reporting and inadequate resources in some areas should further be examined.
In: Acta Medica Philippina, 2006 vol. 40 (1) pages: 7-12
Gestational Trophoblastic Disease
Gestational trophoblastic diseases in the Philippines / Ma Stephanie Fay S. Cagayan
Objectives: To describe the Philippine hospital-based prevalence rate of gestational trophoblastic disease (GTD) and to discuss changes in the management of GTD over the past decades. Study Design: A retrospective descriptive study was done with the following as sources of data: published report on the national incidence of GTD from 1977-1984 and its management, the Philippine Obstetrical and Gynecological Society (POGS)- Committee on Nationwide Statistics Reports 1985-1994, the 1997-2001 POGS Annual Reports on Diseases and Procedures, the 1997-2001 POGS Trophoblastic Disease Registry, the 1991-2001 University of the Philippines-Philippine General Hospital (UP-PGH) Trophoblastic Disease Registry and Annual Reports and the 1991-2001 UP-PGH Dept. of Obstetrics and Gynecology Annual Reports on Diseases and Procedures. Results: The prevalence rate of hydatidiform mole dropped from 7/1000 pregnancies in the early 80's to 2.7/1000 pregnancies from 1985-1994 with note of increase to 3.5/1000 in 1997-2001. At the UP-PGH the prevalence rate of hydatidiform mole is 13.96. This is because the hospital is a known tertiary referral center for GTDs. The national prevalence rate of choriocarcinomas and other trophoblastic neoplasias (GTN) has remained almost constant at 0.55 and 0.52 per 1000 pregnancies respectively from 1990-1994 and 1997-2001. Again, PGH showed a high prevalence for choriocarcinoma and other GTN at 8/1000 pregnancies. Because patients with GTD are invariably indigent, modifications on standard treatment practices have been adapted to bring down the cost of chemotherapy without sacrificing survival and remission rates such as outpatient treatment with methotrexate as chemoprophylaxis and treatment for low risk GTN and use of modified EMA-CO for high risk GTN. Surgery has been widely used as an adjunct to treatment. Conclusion: Despite advances in diagnosis and management of GTD, GTD remains a disease to reckon with in the country. Reasons for poor outcome such as poor patient compliance, inadequate/poor quality of reporting and inadequate resources in some areas should further be examined.
In: Acta Medica Philippina, 2006 vol. 40 (1) pages: 7-12
Gestational Trophoblastic Disease