DOI: 10.38053/acmj.1972676 ISSN: 2718-0115

Clinical characteristics, treatment outcomes, and factors associated with postmolar gestational trophoblastic neoplasia in patients with hydatidiform mole: a single-center retrospective cohort study

Ayşe Hazırbulan, Rukiye Akman, Taşkın Erkinüresin, Tolga Çiftpınar, Ozgur Akbayir, Merve Aldıkaçtıoğlu Talmaç
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Aims: This study evaluated the clinical, laboratory, ultrasonographic, histopathological, treatment, and follow-up characteristics of patients with molar pregnancy and assessed the clinical relevance of baseline factors associated with the development of postmolar gestational trophoblastic neoplasia (GTN) in a contemporary single-center cohort.Methods: This retrospective cohort included 259 patients with hydatidiform mole. Demographic, clinical, laboratory, ultrasonographic, histopathological, treatment, and follow-up data were reviewed. Patients with unknown GTN status were excluded from comparative analyses. Group comparisons used the Mann-Whitney U, Chi-square, or Fisher’s exact test. Multivariable logistic regression was used to evaluate factors independently associated with postmolar GTN development. Firth-penalized logistic regression and a sensitivity analysis restricted to patients with adequate follow-up were additionally performed to assess the robustness of the findings.Results: Among 259 patients, partial hydatidiform mole was diagnosed in 163 patients (62.9%), complete hydatidiform mole in 80 (30.9%), and hydatidiform mole of unspecified subtype in 16 (6.2%). Postmolar GTN developed in 39 patients (15.1%), while GTN status was unknown in 12 (4.6%). Chemotherapy was administered to 33 patients (12.7%); all received a methotrexate folinic acid regimen. Overall, normalization of beta-human chorionic gonadotropin (β-hCG) was achieved in 247 patients (95.4%). In multivariable analysis, initial β-hCG level per 100.000 mIU/ml increase (adjusted OR, 1.34; 95% CI, 1.15-1.56; p

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