The mission of the RMTQ

Huahine – Polynesia

The mission of the RMTQ

Objectives and mission of the RMTQ

The main objective of the Quebec Trophoblastic Disease Network (RMTQ) is to optimize the management of diseases (hydatidiform mole, gestational trophoblastic diseases – GTD) and gestational trophoblastic neoplasias – GTN or choriocarcinoma, invasive mole, PSTT, ETT. Individualized management of these patients requires anatomical-pathological confirmation of the diagnosis and a semi-logarithmic curve of βhCG for an appropriate choice of the type of treatment. The RMTQ offers doctors who wish it information and support for their patients suffering from trophoblastic disease. It is recognized by the following associations:

  • Directorate General of Oncology (DGC)
  • Association of Gynecologists Oncologists of Quebec (RGOQ)
  • Association of Obstetricians Gynecologists of Quebec (AOGQ)
  • Association of Hematologists and Oncologists of Quebec (AMHOQ)
  • Association of Pathologists of Quebec (APQ)

In 1998, the Quebec program for the fight against cancer (PQLC) published the report of the advisory committee establishing that " Quebec should have a center for trophoblastic diseases like those that exist in other Canadian provinces and in several American states ( ISBN 2-551-18830-X, p. 114 ).

This centre, attached to a supra-regional team, should have a register, a processing and follow-up system, the responsibility of promoting teaching and providing the necessary information to stakeholders at all levels and the responsibility of promoting research. The conclusion of this report is that “The creation of such a center would contribute to reducing the costs attributable to the treatment of trophoblastic diseases in Quebec and would improve services and the quality of care”.

The rarity of this condition means that it is often poorly understood and requires specific guidelines as well as the consultation of practitioners from various disciplines: gynecologist-oncologists, obstetrician-gynecologists, oncologists, radiologists, radiotherapists, pathologists and biologists.

SOGC/GOC Clinical Guideline #408, January 2021

The creation of centralized registries should be the next priority in the care of patients with GTD. The optimal management of the disease depends on:

  • consolidation of care in specialized centres;
  • exam reviews;
  • consistent, evidence-based treatment decisions;
  • systematic monitoring.

Long-term data will not only help improve our understanding and treatment of this rare disease, but it will also allow us to think about survivorship issues.

2021. Guideline No. 408: Management of Gestational Trophoblastic Diseases. Eiriksson L, Dean E, Sebastianelli A, Salvador S, Comeau R, Jang JH, Bouchard-Fortier G, Osborne R, Sauthier Ph. J Obstet Gynaecol Can;43(1):91-105.

Worldwide survey of the results of treating gestational trophoblastic disease

  • Dr John Brewer, Chicago, 1971 “ Morbidity and mortality are 9 times lower during the management of trophoblastic diseases with or in a reference center than by inexperienced doctors ”.
  • Dr Ernest Kohorn, 2014:
  • 1995-2005, N = 25,662, 17 countries, 31 MD specialists in GTD.
  • Overall mortality of GTN (20 centers) :
  • Primary Tx with Reference Unit: 2.1% (59/2'818)
  • Referred after 1st relapse : 10.6% (149/1,404)

CHM mortality

UK0.02%
France0.14%
Holland0%
USA1.4%
Brazil0.7%
Canada?

GTN mortality

NOTGTNDCD
MHC13'7622’853 (20.7%)166
(1.2% CHM, 5.8% GTN)
PHM10’074352 (3.5%)*0
CC52771 (13.5%)
PSTT13422 (16.4%)

*confirmed by ploidy and IHC

1971. Gestational trophoblastic disease: A comparative study of the results of therapy in patients with invasive mole and with choriocarcinoma . J Brewer, Am J Obstet Gynecol 1971; 109:335.

2014. Worldwide survey of the results of treating gestational trophoblastic disease. E Kohorn, J Reprod Med 2014; 145-153.

Modified on 12/22/2023