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

Autori
Perković, Pavo ; Vince, Katja ; Matijević, Ratko

Izvornik
Acta medica Croatica (1330-0164) 73 (2018), 3; 319-323

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

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

Sažetak
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.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA