engleski

Methotrexate therapy in gynecologic patients: four- year experience at a tertiary referral center

Aim. The aim of this study was to present methotrexate treatment results of ectopic pregnancy and gestational trophoblastic neoplasia (GTN) in a tertiary referral center. Methods. A retrospective case-series study was conducted using data from records of patients treated with methotrexate during a 4-year period at University Hospital Merkur in Zagreb, Croatia. The study included 11 patients, which were divided into 2 groups: 6 patients with ectopic pregnancy (5 tubal and 1 cornual) and 5 patients with low-risk GTN. Patients with ectopic pregnancy were treated with single dose methotrexate protocol (1 mg/kg/day intramuscularly), while those with low-risk GTN were treated with the 8-day single- agent methotrexate along with leucovorin rescue protocol. Results. Among 5 tubal pregnancies, methotrexate treatment was successful in 4 cases (80%), while 1 patient required surgical treatment. One case of cornual pregnancy case also required surgical treatment after ineffective methotrexate treatment. Of 5 GTN cases treated with methotrexate, 3 required further EMA-CO treatment and 1 required additional surgical treatment, resulting with an overall success rate of methotrexate treatment of 20%. Conclusion. Methotrexate is a valuable medication for treatment of appropriately selected ectopic pregnancy cases, while its usefulness and efficiency for treatment of low-risk GTN diseases has not been confirmed.

methotrexate, ectopic pregnancy, gestational trophoblastic disease, gestational trophoblastic neoplasia, invasive mole, choriocarcinoma

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