Outcome of chemotherapy for gestational trophoblastic disease in Aminu Kano teaching hospital: A 5-year review

Abstract

Background: Gestational trophoblastic diseases are the first and only disseminated solid tumours that have proved to be highly curable by chemotherapy. Chemotherapy can be used for both the premalignant and malignant forms with cure rates of upto 100% in hydatidiform moles and low risk GTD while in high risk GTDs, cure rates of 80 -90% have been achieved. Objectives: To determine the outcome of chemotherapy for gestational trophoblastic disease in Aminu Kano Teaching Hospital, Kano. Study design: Retrospective study of the outcome of chemotherapy for gestational trophoblastic disease in Aminu Kano Teaching Hospital between 1st January 2013 and 31st December 2017. Results: The prevalence of GTD was 6.2/1000 (1 in 160) deliveries and it accounted for 2.8% of gynaecological admissions over the study period. The indications for chemotherapy for GTD in Aminu Kano Teaching Hospital were persistent GTD, choriocarcinoma and invasive mole. Complete remission was achieved in 83.4% of cases and this falls within the 80-100% reported by the American cancer society while relapse and refractory disease were observed in 8.3% each. Overall, the default rate was high (68.5%) for all the treatment modalities and a case fatality rate of 2.9% was observed.Conclusion: The cure rate of 83.4% found in this study is within the 80-90% cure rates reported for high-risk gestational trophoblastic disease. However, the default rate was high (68.5%) for the various treatment modalities and needs to be improved upon.