Table 3.
Summary of Results of Secondary Outcomes and Sensitivity Analyses for Cumulative Incidence of Gestational Trophoblastic Neoplasia After Complete Compared With Partial Molar Pregnancy
| Outcome | Included Studies | Complete Mole | Partial Mole | RR (95% CI) | Heterogeneity (I2) (%) |
|---|---|---|---|---|---|
| GTN after normal hCG level | |||||
| Overall | 19 | 64/18,357 (0.35) | 5/14,864 (0.03) | 4.72 (1.81–12.3) | 19 |
| By time from normal to GTN | |||||
| Less than 1 mo | 17 | 6/16,545 (0.04) | 0/14,864 (0) | 7.10 (0.83–60.7) | 0 |
| Less than 6 mo | 17 | 22/16,536 (0.13) | 3/14,864 (0.02) | 3.16 (0.54–18.7) | 48 |
| More than 6 mo | 10 | 34/16,194 (0.21) | 2/13,928 (0.01) | 4.36 (0.90–21.1) | 41 |
| Sensitivity to risk of bias* | |||||
| Adequate follow-up | 12 | 61/15,885 (0.38) | 5/13,464 (0.04) | 5.10 (1.70–15.3) | 31 |
| Similar co-interventions | 12 | 51/16,951 (0.30) | 4/14,215 (0.03) | 6.87 (2.85–16.6) | 0 |
| Sensitivity to treatment or assay | |||||
| Standard upfront treatment | 17 | 58/17,402 (0.33) | 4/14,289 (0.03) | 6.87 (2.85–16.6) | 0 |
| Sensitive serum hCG assay | 11 | 22/3,703 (0.59) | 2/1,727 (0.12) | 2.53 (0.53–12.2) | 29 |
| Standard treatment+sensitive serum hCG | 10 | 16/3,233 (0.49) | 1/1,603 (0.06) | 5.78 (1.08–30.9) | 0 |
| Sensitivity to undifferentiated† | |||||
| Assumed all CM | 21 | 74/19,287 (0.38) | 5/14,864 (0.03) | 4.72 (1.81–12.3) | 19 |
| Assumed half CM, half PM | 21 | 69/18,847 (0.37) | 10/15,304 (0.07) | 3.25 (1.17–9.01) | 47 |
| GTN overall | 16 | 1,354/8,611 (15.7) | 221/5,593 (3.95) | 4.64 (3.01–7.13) | 78 |
RR, relative risk; GTN, gestational trophoblastic neoplasia; hCG, human chorionic gonadotropin; CM, complete mole; PM, partial mole.
Data are n or n/N (%) unless otherwise specified.
Standard upfront treatment=uterine evacuation or hysterectomy in select cases.
Sensitive serum hCG assay considered normal at less than 5 international units/L, assumed for serum assays after the year 2000.
*
Excluding studies at high risk of bias for the indicated categories.