Evaluation of a routine second curettage for hydatidiform mole: a cohort study
Objective The aim of this study was to evaluate routine second curettage for hydatidiform mole (HM) by comparing the characteristics and outcomes of developing gestational trophoblastic neoplasia (GTN). Study design This was a cohort study including 173 patients diagnosed with HM between January 200...
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| Veröffentlicht in: | International journal of clinical oncology 2020-06, Vol.25 (6), p.1178-1186 |
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| container_title | International journal of clinical oncology |
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| creator | Yamamoto, Eiko Nishino, Kimihiro Niimi, Kaoru Watanabe, Eri Oda, Yukari Ino, Kazuhiko Kikkawa, Fumitaka |
| description | Objective
The aim of this study was to evaluate routine second curettage for hydatidiform mole (HM) by comparing the characteristics and outcomes of developing gestational trophoblastic neoplasia (GTN).
Study design
This was a cohort study including 173 patients diagnosed with HM between January 2002 and August 2019 who were followed up at Nagoya University Hospital, Japan. After an evacuation, 105 and 68 patients were managed with the routine method (routine group) and elective method (elective group) for a second curettage, respectively. The routine second curettage was performed around 7 days after the first evacuation. Patients in the elective group underwent a second curettage if there was ultrasonographic evidence of molar remnants in the uterine cavity. Socio-clinical factors were retrospectively compared between the routine and elective groups, and between patients showing regression and those who developed GTN.
Results
The incidence of GTN was 15.2% in the routine group and 20.6% in the elective group, and the difference was not significant (
P
= 0.364). The median GTN risk score was significantly higher in the routine group than in the elective group (
P
= 0.033). Presence of a complete HM, gestational age, and a pre-treatment human chorionic gonadotropin level of ≥ 200,000 mIU/mL were independent risk factors for GTN in molar patients.
Conclusion
The incidence of GTN was unchanged but the risk score of GTN was higher in the routine group than in the elective group. Routine second curettage may not be necessary, but further study will be needed to confirm this. |
| doi_str_mv | 10.1007/s10147-020-01640-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2374356954</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2407816918</sourcerecordid><originalsourceid>FETCH-LOGICAL-c509t-a082a1877a48f2f40d803171c02293ed746432bbc79a15d0c6dbb1ef60c64b883</originalsourceid><addsrcrecordid>eNp9kEtLxTAQhYMoPq7-ARcScOOmOpOkTetOLr5AdKPrkCapVtpGk1a8_95crw9w4WoOzHfODIeQfYRjBJAnEQGFzIBBBlgIyN7XyDYKLjMpJVtPmgvMqoLlW2QnxmcAlEXONskWZyhEDtU2uT1_092kx9YP1DdU0-CnsR0cjc74wVIzBTeO-tHRxgf6tLAJtW3SPe19506Tw_gnH0Yax8kudslGo7vo9r7mjDxcnN_Pr7Kbu8vr-dlNZtLVMdNQMo2llFqUDWsE2BI4SjTAWMWdlaIQnNW1kZXG3IIpbF2ja4qkRF2WfEaOVrkvwb9OLo6qb6NxXacH56eoGJeC50WVi4Qe_kGf_RSG9J1iAmSJRYXLQLaiTPAxBteol9D2OiwUglq2rVZtq9S2-mxbvSfTwVf0VPfO_li-600AXwExrYZHF35v_xP7AcmEibI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2407816918</pqid></control><display><type>article</type><title>Evaluation of a routine second curettage for hydatidiform mole: a cohort study</title><source>SpringerLink Journals</source><creator>Yamamoto, Eiko ; Nishino, Kimihiro ; Niimi, Kaoru ; Watanabe, Eri ; Oda, Yukari ; Ino, Kazuhiko ; Kikkawa, Fumitaka</creator><creatorcontrib>Yamamoto, Eiko ; Nishino, Kimihiro ; Niimi, Kaoru ; Watanabe, Eri ; Oda, Yukari ; Ino, Kazuhiko ; Kikkawa, Fumitaka</creatorcontrib><description>Objective
The aim of this study was to evaluate routine second curettage for hydatidiform mole (HM) by comparing the characteristics and outcomes of developing gestational trophoblastic neoplasia (GTN).
Study design
This was a cohort study including 173 patients diagnosed with HM between January 2002 and August 2019 who were followed up at Nagoya University Hospital, Japan. After an evacuation, 105 and 68 patients were managed with the routine method (routine group) and elective method (elective group) for a second curettage, respectively. The routine second curettage was performed around 7 days after the first evacuation. Patients in the elective group underwent a second curettage if there was ultrasonographic evidence of molar remnants in the uterine cavity. Socio-clinical factors were retrospectively compared between the routine and elective groups, and between patients showing regression and those who developed GTN.
Results
The incidence of GTN was 15.2% in the routine group and 20.6% in the elective group, and the difference was not significant (
P
= 0.364). The median GTN risk score was significantly higher in the routine group than in the elective group (
P
= 0.033). Presence of a complete HM, gestational age, and a pre-treatment human chorionic gonadotropin level of ≥ 200,000 mIU/mL were independent risk factors for GTN in molar patients.
Conclusion
The incidence of GTN was unchanged but the risk score of GTN was higher in the routine group than in the elective group. Routine second curettage may not be necessary, but further study will be needed to confirm this.</description><identifier>ISSN: 1341-9625</identifier><identifier>EISSN: 1437-7772</identifier><identifier>DOI: 10.1007/s10147-020-01640-x</identifier><identifier>PMID: 32144509</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Cancer Research ; Chorionic gonadotropin ; Cohort analysis ; Curettage ; Gestational age ; Gonadotropins ; Hydatidiform mole ; Medicine ; Medicine & Public Health ; Oncology ; Original Article ; Patients ; Pituitary (anterior) ; Risk factors ; Surgical Oncology ; Uterus</subject><ispartof>International journal of clinical oncology, 2020-06, Vol.25 (6), p.1178-1186</ispartof><rights>Japan Society of Clinical Oncology 2020</rights><rights>Japan Society of Clinical Oncology 2020.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c509t-a082a1877a48f2f40d803171c02293ed746432bbc79a15d0c6dbb1ef60c64b883</citedby><cites>FETCH-LOGICAL-c509t-a082a1877a48f2f40d803171c02293ed746432bbc79a15d0c6dbb1ef60c64b883</cites><orcidid>0000-0002-0517-5091</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10147-020-01640-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10147-020-01640-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32144509$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yamamoto, Eiko</creatorcontrib><creatorcontrib>Nishino, Kimihiro</creatorcontrib><creatorcontrib>Niimi, Kaoru</creatorcontrib><creatorcontrib>Watanabe, Eri</creatorcontrib><creatorcontrib>Oda, Yukari</creatorcontrib><creatorcontrib>Ino, Kazuhiko</creatorcontrib><creatorcontrib>Kikkawa, Fumitaka</creatorcontrib><title>Evaluation of a routine second curettage for hydatidiform mole: a cohort study</title><title>International journal of clinical oncology</title><addtitle>Int J Clin Oncol</addtitle><addtitle>Int J Clin Oncol</addtitle><description>Objective
The aim of this study was to evaluate routine second curettage for hydatidiform mole (HM) by comparing the characteristics and outcomes of developing gestational trophoblastic neoplasia (GTN).
Study design
This was a cohort study including 173 patients diagnosed with HM between January 2002 and August 2019 who were followed up at Nagoya University Hospital, Japan. After an evacuation, 105 and 68 patients were managed with the routine method (routine group) and elective method (elective group) for a second curettage, respectively. The routine second curettage was performed around 7 days after the first evacuation. Patients in the elective group underwent a second curettage if there was ultrasonographic evidence of molar remnants in the uterine cavity. Socio-clinical factors were retrospectively compared between the routine and elective groups, and between patients showing regression and those who developed GTN.
Results
The incidence of GTN was 15.2% in the routine group and 20.6% in the elective group, and the difference was not significant (
P
= 0.364). The median GTN risk score was significantly higher in the routine group than in the elective group (
P
= 0.033). Presence of a complete HM, gestational age, and a pre-treatment human chorionic gonadotropin level of ≥ 200,000 mIU/mL were independent risk factors for GTN in molar patients.
Conclusion
The incidence of GTN was unchanged but the risk score of GTN was higher in the routine group than in the elective group. Routine second curettage may not be necessary, but further study will be needed to confirm this.</description><subject>Cancer Research</subject><subject>Chorionic gonadotropin</subject><subject>Cohort analysis</subject><subject>Curettage</subject><subject>Gestational age</subject><subject>Gonadotropins</subject><subject>Hydatidiform mole</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Pituitary (anterior)</subject><subject>Risk factors</subject><subject>Surgical Oncology</subject><subject>Uterus</subject><issn>1341-9625</issn><issn>1437-7772</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kEtLxTAQhYMoPq7-ARcScOOmOpOkTetOLr5AdKPrkCapVtpGk1a8_95crw9w4WoOzHfODIeQfYRjBJAnEQGFzIBBBlgIyN7XyDYKLjMpJVtPmgvMqoLlW2QnxmcAlEXONskWZyhEDtU2uT1_092kx9YP1DdU0-CnsR0cjc74wVIzBTeO-tHRxgf6tLAJtW3SPe19506Tw_gnH0Yax8kudslGo7vo9r7mjDxcnN_Pr7Kbu8vr-dlNZtLVMdNQMo2llFqUDWsE2BI4SjTAWMWdlaIQnNW1kZXG3IIpbF2ja4qkRF2WfEaOVrkvwb9OLo6qb6NxXacH56eoGJeC50WVi4Qe_kGf_RSG9J1iAmSJRYXLQLaiTPAxBteol9D2OiwUglq2rVZtq9S2-mxbvSfTwVf0VPfO_li-600AXwExrYZHF35v_xP7AcmEibI</recordid><startdate>20200601</startdate><enddate>20200601</enddate><creator>Yamamoto, Eiko</creator><creator>Nishino, Kimihiro</creator><creator>Niimi, Kaoru</creator><creator>Watanabe, Eri</creator><creator>Oda, Yukari</creator><creator>Ino, Kazuhiko</creator><creator>Kikkawa, Fumitaka</creator><general>Springer Singapore</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0517-5091</orcidid></search><sort><creationdate>20200601</creationdate><title>Evaluation of a routine second curettage for hydatidiform mole: a cohort study</title><author>Yamamoto, Eiko ; Nishino, Kimihiro ; Niimi, Kaoru ; Watanabe, Eri ; Oda, Yukari ; Ino, Kazuhiko ; Kikkawa, Fumitaka</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c509t-a082a1877a48f2f40d803171c02293ed746432bbc79a15d0c6dbb1ef60c64b883</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Cancer Research</topic><topic>Chorionic gonadotropin</topic><topic>Cohort analysis</topic><topic>Curettage</topic><topic>Gestational age</topic><topic>Gonadotropins</topic><topic>Hydatidiform mole</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Pituitary (anterior)</topic><topic>Risk factors</topic><topic>Surgical Oncology</topic><topic>Uterus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yamamoto, Eiko</creatorcontrib><creatorcontrib>Nishino, Kimihiro</creatorcontrib><creatorcontrib>Niimi, Kaoru</creatorcontrib><creatorcontrib>Watanabe, Eri</creatorcontrib><creatorcontrib>Oda, Yukari</creatorcontrib><creatorcontrib>Ino, Kazuhiko</creatorcontrib><creatorcontrib>Kikkawa, Fumitaka</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yamamoto, Eiko</au><au>Nishino, Kimihiro</au><au>Niimi, Kaoru</au><au>Watanabe, Eri</au><au>Oda, Yukari</au><au>Ino, Kazuhiko</au><au>Kikkawa, Fumitaka</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of a routine second curettage for hydatidiform mole: a cohort study</atitle><jtitle>International journal of clinical oncology</jtitle><stitle>Int J Clin Oncol</stitle><addtitle>Int J Clin Oncol</addtitle><date>2020-06-01</date><risdate>2020</risdate><volume>25</volume><issue>6</issue><spage>1178</spage><epage>1186</epage><pages>1178-1186</pages><issn>1341-9625</issn><eissn>1437-7772</eissn><abstract>Objective
The aim of this study was to evaluate routine second curettage for hydatidiform mole (HM) by comparing the characteristics and outcomes of developing gestational trophoblastic neoplasia (GTN).
Study design
This was a cohort study including 173 patients diagnosed with HM between January 2002 and August 2019 who were followed up at Nagoya University Hospital, Japan. After an evacuation, 105 and 68 patients were managed with the routine method (routine group) and elective method (elective group) for a second curettage, respectively. The routine second curettage was performed around 7 days after the first evacuation. Patients in the elective group underwent a second curettage if there was ultrasonographic evidence of molar remnants in the uterine cavity. Socio-clinical factors were retrospectively compared between the routine and elective groups, and between patients showing regression and those who developed GTN.
Results
The incidence of GTN was 15.2% in the routine group and 20.6% in the elective group, and the difference was not significant (
P
= 0.364). The median GTN risk score was significantly higher in the routine group than in the elective group (
P
= 0.033). Presence of a complete HM, gestational age, and a pre-treatment human chorionic gonadotropin level of ≥ 200,000 mIU/mL were independent risk factors for GTN in molar patients.
Conclusion
The incidence of GTN was unchanged but the risk score of GTN was higher in the routine group than in the elective group. Routine second curettage may not be necessary, but further study will be needed to confirm this.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>32144509</pmid><doi>10.1007/s10147-020-01640-x</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-0517-5091</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1341-9625 |
| ispartof | International journal of clinical oncology, 2020-06, Vol.25 (6), p.1178-1186 |
| issn | 1341-9625 1437-7772 |
| language | eng |
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| source | SpringerLink Journals |
| subjects | Cancer Research Chorionic gonadotropin Cohort analysis Curettage Gestational age Gonadotropins Hydatidiform mole Medicine Medicine & Public Health Oncology Original Article Patients Pituitary (anterior) Risk factors Surgical Oncology Uterus |
| title | Evaluation of a routine second curettage for hydatidiform mole: a cohort study |
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