The management of hydatidiform mole with lung nodule: a retrospective analysis in 53 patients.

Abstract

OBJECTIVE:

To investigate the significance of lung nodule in hydatidiform mole, we retrospectively compared the clinical outcomes of those patients treated with different strategies.

METHODS:

The patients were divided into three groups: chemotherapy immediately once lung nodule was detected (group 1, n=17), delayed chemotherapy until human chorionic gonadotrophin (hCG) level met the diagnostic criteria for gestational trophoblastic neoplasia (GTN) (group 2, n=18), and hCG surveillance alone until hCG level was normalized spontaneously (group 3, n=18). The clinical parameters of these patients were collected and analyzed.

RESULTS:

Totally 53 (4.0%) patients were included from 1,323 cases with molar pregnancy during past 16 years. Among them, the diameters of lung nodules were 0.3-2.5 cm. Chemotherapy cycles for achieving hCG normalization and the failure rate of first-line chemotherapy in group 1 were significantly increased than that in group 2 (5 vs. 3 cycles, p=0.000, 58.8% vs. 11.1%, p=0.005). The hCG level of all 18 cases in group 3 was normalized spontaneously within 6 months. Of those, lung nodules of 9 patients disappeared spontaneously, accounting for 25% (9/36) of patients who initially selected observation. The proportion of single nodule in group 3 was significantly higher than that in group 2 (10/18 vs. 2/18, p=0.012).

CONCLUSION:

Our results suggest that lung nodule alone is not an adequate indication of chemotherapy in molar pregnancy. hCG surveillance is safe for patients with lung nodule, especially with single nodule, as long as their hCG levels do not meet International Federation of Gynecology and Obstetrics diagnostic criteria for GTN.

• Authors: Xiao Li, Yaping Xu, Yuanyuan Liu, Xiaodong Cheng, Xinyu Wang, Weiguo Lu, Xing Xie
• Journal: Journal of gynecologic oncology (J Gynecol Oncol) Vol. 30 Issue 2 Pg. e16 (Mar 2019) ISSN: 2005-0399 [Electronic] Korea (South)
• PMID: 30740949 (Publication Type: Journal Article)
• Copyright: Copyright © 2019. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.

Chemical References

• Antineoplastic Agents
• Chorionic Gonadotropin

Topics

• Adolescent
• Adult
• Antineoplastic Agents (therapeutic use)
• Chorionic Gonadotropin (blood)
• Female
• Follow-Up Studies
• Humans
• Hydatidiform Mole (therapy)
• Lung (diagnostic imaging, pathology)
• Lung Neoplasms (secondary, therapy)
• Middle Aged
• Pregnancy
• Remission Induction
• Remission, Spontaneous
• Retrospective Studies
• Tomography, X-Ray Computed
• Uterine Neoplasms (therapy)
• Young Adult