1.Comparison of beta‑human chorionic gonadotropin‑based prognostic models on the clinical outcomes of gestational trophoblastic disease patients in the Philippines
Alvin Duke R. Sy ; Maria Stephanie Fay Samadan Cagayan
Philippine Journal of Obstetrics and Gynecology 2023;47(3):99-107
Objective:
Despite the widespread use and measurement of beta‑human chorionic
gonadotropin (β‑HCG) among hydatidiform mole (HM) patients, models derived from this biomarker
to predict the remission or postmolar gestational trophoblastic neoplasia (GTN) rarely perform
well. The study aimed to generate cutoff points for postevacuation β‑HCG levels and evaluate their
performance among women with complete molar pregnancies
Methods:
A retrospective cohort study composed of women with complete HM underwent bivariate
procedures comparing characteristics between the comparison groups. Cut points using Liu’s and
Youden’s indices were estimated, and their performance was evaluated using receiver operating
characteristic curve analysis. Cox regression to compare time‑to‑progression across these proposed
β‑HCG cutoffs was also performed.
Results:
The incidence of postmolar GTN among the 155 women in the study was 15.5% (95%
confidence interval: 10.2%–22.2%). Postevacuation HCG levels had a better prediction of disease
status than preevacuation and HCG ratio models (χ2
: 163.07, P < 0.01). A cutoff at 508 mIU/mL the
3rd‑week postevacuation (area under the curve [AUC]: 0.89, sensitivity: 87.5%, specificity: 90.1%) was
comparable with the 185 mIU/mL cutoff at the 5th‑week postevacuation (AUC: 0.89, sensitivity: 91.7%,
specificity: 87%). The hazards ratio of postmolar GTN was 29.74 (8.53–103.71) and 39.89 (8.82–180.38)
for the 3rd and 5th weeks HCG after evacuation adjusting for clinically relevant variables
Conclusion
The first 3rd‑ and 5th‑week postevacuation levels of β‑HCG demonstrated potential
in predicting postmolar GTN. However, further refinement and adjustment for clinically relevant risk
factors are still needed.
Choriocarcinoma
;
Gestational Trophoblastic Disease
;
Prognosis
2.Qualitative assessment of the concerns on treatment and patient health among patients with gestational trophoblastic neoplasia and their caregivers during the COVID-19 pandemic
Jessabeth Bibat Mercado ; Maria Febi Billones De Ramos ; Maria Stephanie Fay Samadan Cagayan
Philippine Journal of Obstetrics and Gynecology 2023;47(3):129-134
Background:
The COVID-19 pandemic has immobilized and impaired the operation of hospitals,
clinics, and other health-care facilities leaving a plethora of patients and persons-at-risk in a more
precarious position. Cancer patients were vulnerable to infections and complications due to the
nature of the malignancy. Their caregivers were likewise predisposed to infection while taking care
of them. This paper focused on determining the concerns of both gestational trophoblastic neoplasia
(GTN) patients and their caregivers and identified possible factors of improvement in the delivery
of essential cancer care.
Objective:
The objective of the study was to describe the different concerns of GTN patients
and their caregivers during chemotherapy and other adjunctive treatments during the COVID-19
pandemic in a Tertiary Government Hospital.
Materials and methods:
A qualitative type of research was employed in this research, for
which an in-depth interview was used. A total of 12 respondents, 6 patients and 6 caregivers, were
interviewed using a semi-structured pretested questionnaire.
Results:
Findings showed that infection with COVID-19, financial and logistical constraints
exacerbated by the pandemic were the main concerns of both patients and caregivers. Other
concerns recorded include change in their attending physician, survivability of the patient, and the
availability of caregivers.
Conclusions
Despite the recorded apprehensions from the patients and caregivers, there was
a general satisfaction in the delivery of health care at the Division of Trophoblastic Diseases due to
the clarity in the follow-up and treatment schedules which have been optimized through the revised
guidelines and protocols set by the division to adapt to the COVID-19 pandemic.
COVID-19
;
3.Risk determination of COVID-19 among unvaccinated nonpregnant women in Metro Manila, Philippines: A multicenter longitudinal cohort study
Erlidia Flores Llamas‑Clark ; Francisco M. Heralde III ; Mayan U. Lumandas ; Maria Esterlita T. Villanueva‑Uy ; Leilani C. Chavez‑Coloma ; Eleyneth I. Valencia ; Cynthia U. Anzures ; Maria Lu D. Andal ; Carolina Paula C. Martin ; Vanessa D. De Guzman ; Ryan B. Capitulo ; Arlene R. Dominguez ; Abygail L. Recio ; Jeremiah Francisco Feliciano ; Paulyn Jean Buenaflor Rosell‑Ubial ; Emmanuel S. Baja ; Maria Stephanie Fay Samadan Cagayan
Philippine Journal of Obstetrics and Gynecology 2023;47(6):302-311