Changing trends in the management of gestational trophoblastic diseases in the Philippines.

OBJECTIVE

To describe the Philippine hospital-based prevalence rate of gestational trophoblastic disease (GTD) and to discuss changing trends in its management.

STUDY

DESIGN

A retrospective descriptive study was done using local hospital based epidemiologic data. Charts of diagnosed GTD patients from 2002-2008 were reviewed for data analysis including sociodemographic and clinical profile, International Federation of Obstetrics and Gynecology staging and World Health Organization prognostic scoring, chemotherapy used and remission rates.

RESULTS

The national prevalence rate of hydatidiform mole is 2.4/1,000 pregnancies during the years 2002-2008. At the University of Philippines-Philippine General Hospital (UP-PGH) the prevalence rate of hydatidiform mole is 14/1,000 pregnancies. The national prevalence rate of choriocarcinomas and other gestational trophoblastic neoplasias (GTNs) has remained almost constant at 0.56/1,000 pregnancies. Again, UP-PGH showed a high prevalence for choriocarcinoma and other GTNs at 4.3/1,000 pregnancies. Because patients with GTD are invariably indigent, modifications to standard treatment practices have been adapted to bring down the cost of chemotherapy without sacrificing survival and remission rates.

CONCLUSION

Current outcomes of treatment for Filipino GTN patients appear much improved. This might be due to increased efforts of trophoblast specialists to educate other physicians in the prompt recognition of the disease, initial management and appropriate referral of these patients to specialty centers.