Clinical-epidemiological characterization of patients with choriocarcinoma in a hospital in Honduras, 2009-2022

Abstract

Introduction: Choriocarcinoma is a malignant neoplasm of the cytotrophoblast and syncytiotrophoblast, classified as gestational, non-gestational, and intraplacental. It’s risk factors include advanced maternal age, history of hydatidiform mole, and elevated levels of Human Chorionic Gonadotropin (HCG). Diagnosis is based on serum HCG levels and imaging. Given the absence of prior studies, this research is crucial for understanding choriocarcinoma in the Honduran population, allowing the establishment of a local epidemiological profile. Objective: To characterize patients with choriocarcinoma at Hospital General San Felipe during 2009-2022. Methods: An observational, retrospective descriptive study, with 30 patients selected non-probabilistically. Measures of central tendency, frequencies, percentages, and statistical tests (Kruskal-Wallis and Chi-square) were analyzed. Results: The mean age was 32.4 years; 40% were over 35 years old. Rural origin predominated (60%). 76.7% had inter-pregnancy intervals >12 months. 96.7% were gestational choriocarcinomas, with tumors >5 cm (63.3%) and HCG levels >100,000 UI/L (70%). According to the International Federation of Gynecology and Obstetrics (FIGO), 26.7% were at Stage IV; 66.7% had metastases, mainly pulmonary. A direct statistical association was demonstrated between elevated HCG levels and advanced stages of the FIGO classification (p=0.044). Discussion: This study constitutes the first clinical characterization of choriocarcinoma in Honduras. The findings allow establishing relevant clinical relationships for the prognosis of this little-known disease. Specific follow-up coordination is recommended for patients with high-risk obstetric conditions, especially at extreme reproductive ages and with elevated HCG.