EPIDEMIOLOGICAL ASPECTS OF MALIGNANT TROPHOBLASTIC TUMORS IN WOMEN OF THE REPUBLIC OF TAJIKISTAN
SATTOROVA M.A. SANGINOV D.R.
SI “Republican Cancer Research Center” of the Ministry of Health and Social Protection of the Population of the Republic of Tajikistan
Department of Oncology of the Avicenna Tajik State Medical University
Aim. Study of epidemiological aspects of malignant trophoblastic tumors in Tajikistan.
Material and Methods. The data of 224 patients were studied: with invasive bladder drift – 197 (87,9%), with choriocarcinoma – 27 (12,1%). 130 (58%) patients were residents of the city, 94 (42%) – villages. 92 women (41%) lived in the Regions of Republican Subor- dination (RRS), 86 (38,4%) – in Khatlon region, 38 (17%) – in Dushanbe, 4 – from Sughd region and Gorno-Badakhshan Autonomous Region (GBAR). Tajiks among the sick were 89,3% (200 patients), other nationalities (uzbeks, russians, etc.) – 10,7%. A characteristic fea- ture of the patients were early marriages, in 49,1% sexual life began at the age of less than 18 years. 100 (44,6%) were multiparous women. Results. The data shows a steady increase in the incidence of malignant trophoblastic tumors (MTT): 41 (18,3%) cases in 2016 against 10 (4,5%) cases in 2007. The greatest number of patients falls on the period of reproductive activity of women, 18-35 years old (184 patients
– 82%). The mean age of MTT patients is 25,2±3,1 years, for choriocarcinoma – 28 years, for invasive bladder drift – 22 years. During the study period, 5 (2.2%) patients died in diff years: from brain metastases – 2 (0,89%), uterine perforation -1 (0,45%); bleeding – 2 (0,89%). The analysis data indicate a relatively high level of morbidity in RRS and Khatlon region, low level – in GBAR. With an increase in the number of pregnancies and abortions, the risk of MTT increases. Alimentary anemia and, especially, its iron defi form was observed in 80% of women.
Conclusion. Factors that increase the risk of malignant trophoblastic tumors are: reproductive age (from 18 to 56 years), the peak inci- dence – 18-35 years; early marriage; frequent pregnancy, childbirth and abortion.
Key words: malignant trophoblastic tumors, epidemiology, risk factors
- Klinicheskiy protokol diagnostiki i lecheniya zlok- achestvennykh trofoblasticheskikh MZ Respub- liki Kazakhstan ot 30 oktyabrya 2015 goda, Protokol №14 [Clinical Protocol of diagnosis and treatment of malignant trophoblastic neoplasms. MOH of the Republic of Kazakh- stan dated October 30, 2015, Protocol No. 14].
- Davydov I., Kuznetsova V. V., Meshcheryakova A. Trofoblasticheskie opukholi. Lektsii po onkoginekologii [Trophoblastic tumors. Lectures on oncogynecology]. Moscow, 2009; 330-47.
- Smit R., Khili D. Onkoginekologicheskiy atlas. Klassifi a i opredelenie stadii opukholey i printsipy diag- nostiki i lecheniya [Oncoynecological atlas. Classifiand defi of tumor stage and principles of diagnosis and treatment]. Moscow, Prakticheskaya meditsina Publ., 2010.
- Kani K., Lee J. H., Dighe M., Gestational tropho- blastic disease: multimodality imaging assessment with special emphasis on spectrum of abnormalities and value of imaging in staging and management of disease. Cur. Problems Diagnostic Radiol., 2012; 41(1): 825–831.
- Lybol , Sweep F. C., Harvey R., Relapse rates after two versus three consolidation courses of methotrexate in the treatment of low-risk gestational trophoblastic neopla- sia. Gynecol Oncol., 2012; 125: 576-579.
- McGrath , Short D., Harvey R., The management and outcome of women with post-hydatidiformmole ”low- risk” gestational trophoblastic neoplasia, but hCG levels in excess of 100 000 IU l(-1). Br. Cancer., 2010; 102: 810-814.
- Moutte , Doret M., Hajri T., Placental site and epi- thelioid trophoblastic tumours: diagnostic pitfalls. Gynecol. Oncol., 2013; 128(3): 568-572.
- Neubauer L., Latif N., Kalakota K., Brain me- tastasis in gestational trophoblastic neoplasia: an update. Reprod Med., 2012; 57(7–8): 288-292.
- Osborne J., Filiaci V., Schink J. C., Phase III trial of weekly methotrexate orpulsed dactinomycin for low-risk gestational trophoblastic neoplasia: a gynecologic oncology group study. J. Clin. Oncol., 2011; 29: 825–831.
- Seckl J., Sebire N. J., Fisher R. A., Gestational trophoblastic disease: ESMO clinical practice guidelines. Ann. Oncol., 2013; 24 (Suppl 6): vi39-vi50.
- Shen , Xiang Y., Guo L., Fertility-preserving treat- ment in young patients with placental site trophoblastic tumors. Int. J. Gynecol. Cancer., 2012; 22(5): 869-874.
Information about authors:
Sanginov Dzhumaboy Rakhmatovich – Doctor of Medical Sciences Professor at the Department of Oncology of the Avicenna Tajik State Medical University; tel.: (+992)935700909; e-mail: email@example.com
Sattorova Mokhiniso Abdultabobovna – State Establishment “Republican Cancer Research Cen- ter” of the Ministry of Health and Social Protec- tion of the Population of the Republic of Tajiki- stan; tel.: + (992) 936028884; e-mail: firstname.lastname@example.org