The role of hysterectomy in the treatment of gestational trophoblastic neoplasms: a single-center experience

Introduction: The main treatment method of gestational trophoblastic neoplasms (GTNs) is chemotherapy. In some situations, surgical treatment including hysterectomy and metastasectomy is required. This study aims to evaluate the experience of a single center with the use of hysterectomy in the treatment of GTNs. Material and methods: Between May 1995 and March 2014, a total of 35 patients treated for GTNs in our center were retrospectively evaluated. Fourteen of them had undergone a hysterectomy as part of their treatment. Chemotherapy regimens prior to hysterectomy, operation indications, post-hysterectomy treatments, morbidity and mortality rates, follow-up and prognosis were evaluated. Descriptive analyses were used to present the findings. Results: Mean age at the time of the hysterectomy was 41 ±5.7 (range: 18–58). Ten (71.4%) patients received single-agent or multi-agent chemotherapy prior to the hysterectomy. Hysterectomy indications were resistance to chemotherapy in 7 (50%) cases, patient’s preference in 4 (28.5%) cases, and intractable bleeding in 3 (21.5%) cases. All hysterectomies were performed transabdominally. There was no mortality or major operative morbidity. Five patients maintained their chemotherapy after hysterectomy as well because they had pulmonary metastasis. Four patients did not receive chemotherapy either preoperatively or postoperatively. Mean follow-up duration after the hysterectomy was 92.6 ±38.5 months (range: 39–180 months). There was no disease recurrence or death during this period. Conclusions: Hysterectomy is a safe and effective treatment method, especially for GTNs which are resistant to conventional treatment.