Beta-human chorionic Gonadotropin levels as early predictor for progression to Gestational Trophoblastic Neoplasia after molar pregnancy evacuation at a Philippine tertiary hospital / Philippine Journal of Obstetrics and Gynecology

ABSTRACT

Objective@#This study aimed to determine if the beta-human chorionic gonadotropin (hCG) levels during the first 5 weeks after a molar evacuation predict progression to gestational trophoblastic neoplasia (GTN).@*Materials and Methods@#This was a retrospective cohort study of complete mole cases managed at a Philippine tertiary hospital from January 2009 to December 2018. Extracted data were analyzed using applicable statistical tools. The level of significance was set at a P < 0.05 using two-tailed comparisons. @*Results@#One hundred and fifty-five complete patient records were available for review. Disease progression in 15.48% of cases while regression in 84.52% were noted. Uterine size was larger in those who eventually had postmolar GTN (t −3.12, df 32.64, P 0.01). Analysis of the receiver operating characteristic curve showed that optimum cut-off levels for predicting GTN at 1, 3, and 5 weeks after evacuation were 4,152 mIU/ml (sensitivity 50%, specificity 94.7%, area under the curve [AUC] 0.75), 804 mIU/ml (sensitivity 62.5, specificity 96.9%, AUC 0.94), and 541 mIU/ml (70.8%, specificity 97.7%, AUC 0.96), respectively. @*Conclusion@#The level of hCG within the first 5 weeks after molar pregnancy evacuation is predictive of progression to GTN.