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METHOTREXATE THERAPY IN GYNECOLOGIC PATIENTS: FOUR-YEAR EXPERIENCE AT A TERTIARY REFERRAL CENTER
PAVO PERKOVIĆ
; Klinička bolnica Merkur, Klinika za ginekologiju i opstetriciju, Zagreb, Hrvatska
KATJA VINCE
orcid.org/0000-0001-5992-5030
; Klinička bolnica Merkur, Klinika za ginekologiju i opstetriciju, Zagreb, Hrvatska
RATKO MATIJEVIĆ
orcid.org/0000-0003-1693-7474
; Klinička bolnica Merkur, Klinika za ginekologiju i opstetriciju i Sveučilište u Zagrebu, Medicinski fakultet, Klinika za ginekologiju i opstetriciju, Zagreb, Hrvatska
Sažetak
Aim: The aim of this study was to present methotrexate treatment results in ectopic pregnancy and gestational trophoblastic neoplasia (GTN) at 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 Merkur University Hospital in Zagreb, Croatia. The study included 11 patients 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), whereas those with low-risk GTN were treated with 8-day single-agent methotrexate along with leucovorin rescue protocol. Results: Among 5 tubal pregnancies, methotrexate treatment was successful in 4 (80%) cases, while one patient required surgical treatment. One case of cornual pregnancy 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, yielding the 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 effi ciency in the treatment of low-risk GTN diseases has not been confi rmed.
Ključne riječi
methotrexate; ectopic pregnancy; gestational trophoblastic disease; gestational trophoblastic neoplasia; invasive mole; choriocarcinoma
Hrčak ID:
208528
URI
Datum izdavanja:
16.11.2018.
Posjeta: 1.490 *