AI Summary & Key Takeaways
AI InsightOverall, normalization of beta-human chorionic gonadotropin (β-hCG) was achieved in 247 patients (95.4%).
📌 3 Key Takeaways
Abstract
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<0.001) and the presence of a theca lutein cyst (adjusted OR, 9.05; 95% CI, 2.33-35.07; p=0.001) were independently associated with postmolar GTN development. These associations remained consistent in Firth-penalized logistic regression and in the sensitivity analysis restricted to patients with adequate follow-up. Conclusion: Established markers of trophoblastic burden, particularly higher initial β-hCG levels and the presence of theca lutein cysts, were independently associated with postmolar GTN in this contemporary cohort. The consistency of these associations across complementary analyses supports the clinical relevance of early biochemical and ultrasonographic assessment, while serial post-evacuation β-hCG surveillance remains the cornerstone of follow-up.