[Choriocarcinoma in Senegal: epidemiology, prognosis and prevention]. / Choriocarcinome au Sénégal: épidémiologie, pronostic et prévention.

OBJECTIVE: The objective of this study was to define the epidemiological profile of choriocarcinoma in Senegal, to evaluate its prognosis and to submit a better way of prevention of this pathology in an area with poor medical care. MATERIAL AND METHOD: It was a retrospective case-control study of all choriocarcinomas diagnosed from January 1st to December 31st 2000 at Dakar university teaching hospital. The witnesses were chosen among patients who had had molar abortion at the same time as the cases at study and had not developed the pathology after at least 12 months of aftercare. The stability of association was checked by calculating the confidence interval in 95% by Miettinen method and using Chi 2 test of Pearson with a risk factor alpha under 5% or Fischer test; the prognosis survival factors were compared by using logrank test. RESULTS: Among the 1098 patients in follow-up treatment after molar abortion, 61 choriocarcinomas were diagnosed with an incidence of 5.5%. The epidemiological profile was a great multiparous (40 years old or more) with low socio-economical level, 51% of the diagnosed cases are made in the metastasis stage. The prognosis was marked by a complete remission in 37.7% and by global lethality in 49.2%; the average survival was about 48 months. DISCUSSION AND CONCLUSION: The risk factors of choriocarcinoma among patients who had a molar abortion were represented by an age superior or equal to 40 years old, high multiparity and preservation of the uterus after molar abortion. To improve the prognosis in a country with low medical care, we recommend to widen preventive hysterectomy indications after molar abortion among patients with risk factors of choriocarcinoma.

[Gestational trophoblastic tumors: epidemiology and prognosis in Dakar University teaching hospital]. / Tumeurs trophoblastiques gestationnelles: épidémiologie et pronostic au CHU de Dakar.

From a prospective and length wise survey, the forecast of the gestational trophoblastics tumours was estimated. Between 1st November 1996 and 31st October 1997, 102 cases of gestational trophoblastics tumours was registered. The medium profile was a "Ouoloff" (54%) or "Serere" (20%), 30 years old, multiparous, without, security social cover (100%). Looking back over 2 to 12 months, 25% of cases has worthily grown; so 10% of cases of choriocarcinoma with 3 death. The average cost of post-molar follow-up was about 120,000 F CFA. Because of the expensive cost of antimitotics, between 180,000 and 278,000 F CFA, their availability wasn't frequent and their use was restricted.