{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T16:38:56Z","timestamp":1762101536946},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2014,3,28]],"date-time":"2014-03-28T00:00:00Z","timestamp":1395964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the risk of recurrent trophoblastic disease after normalisation of human chorionic gonadotrophin (<jats:styled-content style=\"fixed-case\">hCG<\/jats:styled-content>) levels in women with hydatidiform mole.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A retrospective review of data from a national gestational trophoblastic disease centre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>The Trophoblastic Disease Unit, Dakar, Senegal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>Women with pregnancies affected by hydatidiform mole registered between 2006 and 2012.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The women were followed up in accordance with the hospital protocol \u2018Score de Dakar\u2019. For women who progressed to gestational trophoblastic neoplasia (<jats:styled-content style=\"fixed-case\">GTN<\/jats:styled-content>) the time to onset of <jats:styled-content style=\"fixed-case\">GTN<\/jats:styled-content>, treatment and evolution were evaluated. The rate of evolution to <jats:styled-content style=\"fixed-case\">GTN<\/jats:styled-content> after normalisation of <jats:styled-content style=\"fixed-case\">hCG<\/jats:styled-content> was determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Rate of occurrence of <jats:styled-content style=\"fixed-case\">GTN<\/jats:styled-content> after chemotherapy for hydatidiform mole.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five hundred and thirty\u2010one women were diagnosed to have molar pregnancies. According to the hospital's protocol, 107 (20.2%) of these had chemotherapy and 224 (42.2%) had prophylactic chemotherapy. Five hundred and thirteen women (96.4%; 95% confidence interval [95% CI] 95.05\u201398.14%) achieved remission. Eighteen women (3.4%; 95% CI 1.86\u20134.94%) developed <jats:styled-content style=\"fixed-case\">GTN<\/jats:styled-content> (11 before remission and seven after remission). Seven women out of the 18 developed <jats:styled-content style=\"fixed-case\">GTN<\/jats:styled-content> after <jats:styled-content style=\"fixed-case\">hCG<\/jats:styled-content> normalisation (1.3%). Five of these seven were diagnosed beyond the recommended period of follow up. The mean interval to diagnosis of <jats:styled-content style=\"fixed-case\">GTN<\/jats:styled-content> was 18.7\u00a0months. These seven women underwent combination chemotherapy: five achieved complete remission whereas two died from <jats:styled-content style=\"fixed-case\">GTN<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Cytotoxic therapy for hydatidiform mole does not prevent <jats:styled-content style=\"fixed-case\">GTN<\/jats:styled-content>, it delays its diagnosis and promotes <jats:styled-content style=\"fixed-case\">GTN<\/jats:styled-content> after normalisation of <jats:styled-content style=\"fixed-case\">hCG<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.12742","type":"journal-article","created":{"date-parts":[[2014,3,28]],"date-time":"2014-03-28T09:34:57Z","timestamp":1395999297000},"page":"1415-1420","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Gestational trophoblastic neoplasia after achieving a nondetectable serum human chorionic gonadotrophin level"],"prefix":"10.1111","volume":"121","author":[{"given":"M","family":"Gueye","sequence":"first","affiliation":[{"name":"Gynecologic and Obstetric Clinic Aristide Le Dantec Teaching Hospital Cheikh Anta Diop University Dakar Senegal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SM","family":"Kane\u2010Gueye","sequence":"additional","affiliation":[{"name":"Gynecologic and Obstetric Clinic Aristide Le Dantec Teaching Hospital Cheikh Anta Diop University Dakar Senegal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MD","family":"Ndiaye\u2010Gueye","sequence":"additional","affiliation":[{"name":"Gynecologic and Obstetric Clinic Aristide Le Dantec Teaching Hospital Cheikh Anta Diop University Dakar Senegal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Mbaye","sequence":"additional","affiliation":[{"name":"Gynecologic and Obstetric Clinic Aristide Le Dantec Teaching Hospital Cheikh Anta Diop University Dakar Senegal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"AA","family":"Diouf","sequence":"additional","affiliation":[{"name":"Gynecologic and Obstetric Clinic Aristide Le Dantec Teaching Hospital Cheikh Anta Diop University Dakar Senegal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MM","family":"Niang","sequence":"additional","affiliation":[{"name":"Gynecologic and Obstetric Clinic Aristide Le Dantec Teaching Hospital Cheikh Anta Diop University Dakar Senegal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Diallo","sequence":"additional","affiliation":[{"name":"Gynecologic and Obstetric Clinic Aristide Le Dantec Teaching Hospital Cheikh Anta Diop University Dakar Senegal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JC","family":"Moreau","sequence":"additional","affiliation":[{"name":"Gynecologic and Obstetric Clinic Aristide Le Dantec Teaching Hospital Cheikh Anta Diop University Dakar Senegal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,3,28]]},"reference":[{"key":"e_1_2_6_2_1","article-title":"Chemotherapy for resistant or recurrent gestational trophoblastic neoplasia","volume":"12","author":"Alazzam M","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/01443615.2013.771159"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2011.10.035"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60280-2"},{"key":"e_1_2_6_6_1","first-page":"1973","article-title":"Hydatidiform mole in England and Wales","volume":"673","author":"Bagshawe KD","year":"1986","journal-title":"Lancet"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000136099.21216.45"},{"key":"e_1_2_6_8_1","first-page":"8","article-title":"Pr\u00e9vention du choricarcinome postmolaire en milieu africain: exemple du S\u00e9n\u00e9gal","volume":"307","author":"Ciss\u00e9 CT","year":"2005","journal-title":"La Lettre du Gyn\u00e9cologue"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7292(02)00063-2"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2006.06.031"},{"key":"e_1_2_6_11_1","first-page":"249","volume-title":"Gestational Trophoblastic Disease","author":"Berkowitz RS","year":"2009"},{"key":"e_1_2_6_12_1","unstructured":"CNGOF ANM SFMP.Recommandations de bonne pratique clinique. 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