Hydatidiform mole in the elderly: hysterectomy or evacuation?

Ten patients with hydatidiform mole treated by primary hysterectomy were retrospectively compared with 24 patients whose moles were evacuated by suction curettage. All patients were 35 years old or more and were followed up for 1 year following the evacuation. During follow-up, 10% of the hysterectomized patients needed chemotherapy in comparison with 33.4% of the non-hysterectomized patients. This difference was not statistically significant. There was also no statistically significant difference when the serial serum beta-subunit of human chorionic gonadotrophin (beta-hCG) regression rates of the two groups were compared. The study shows that primary hysterectomy does not worsen the prognosis of gestational trophoblastic disease, however, it does not negate the need for careful follow-up.