Hubungan Faktor Risiko terhadap Keberhasilan Terapi MTX Tunggal pada Pasien Gestasional Trophobolastic Neoplasia Low Risk di RSUP Haji Adam Malik Tahun 2016 – 2021

Abstract

Introduction: Gestational trophoblastic neoplasia (GTN) is a group of cancers that develop from the growth of abnormal cells normally found in the placenta. It can be diagnosed after a complete or partial pregnancy, miscarriage, or molar pregnancy, which is when the placenta does not develop normally and forms a tumor. In Indonesia, the incidence of GTN is quite high, namely 1:1000 pregnancies. Women with a previous history of hydatidiform mole have a tendency to experience the risk of developing GTN in subsequent pregnancies. Early knowledge of the risk factors in the form of age, history of pregnancy, serum levels of β-HCG and calculating the correct FIGO score will affect the success of therapy in order to prevent resistance treatment. Method: This study is a retrospective cohort study to assess the relationship of risk factors to the success of single MTX therapy in low-risk GTN patients at HAM Hospital from 2016 - 2021. Initial HCG β assessment, age, history of previous pregnancy, FIGO score, success of therapy with MTX were taken from medical records. Data were tested statistically with Fisher's exact method. Results: This study obtained 31 GTN subjects low riskwith an average age of 38.39 years and an average level of β-HCGpretreatment117,996.74 IU/mL and the average β HCGposttreatmentwas 104,031.64 with a successful remission of 64.5%. Based on age and history of pregnancy such as abortion and moles, there was no association with single MTX administration (p=0.452 and p=0.527). Conversely, there is a relationship between initial β HCG (p=<0.001; RR=7.125; 95% CI 1.845-27.512) and FIGO score (p=<0.001; RR=6.519; 95% CI 2.221-19.131) with the success of single MTX therapy . Conclusion: There is relationship between the initial β HCG and the FIGO score on single MTX therapy. However, there is no relationship between age and history of pregnancy on single MTX therapy in low-risk GTN patients.