目的：对斯洛伐克共和国（SR）流行病学中的侵袭性和转移性葡萄胎（HM）进行回顾性分析，患者特征和治疗结果。
背景：侵袭性和转移性葡萄胎是一种高度可治愈的妊娠滋养细胞瘤。侵袭性和转移性HM均可通过子宫切除术治愈，无需辅助化疗。
方法：从1993年至2022年，SR治疗了19例经组织病理学证实的HM（侵袭性10例，转移性9例）。根据治疗方式将患者分为两组（仅子宫切除术-8；子宫切除术和化疗-11）。分析中包括的参数是患者年龄，前期怀孕，人绒毛膜促性腺激素水平，肿瘤大小和缓解时间。
结果：SR中浸润性和转移性HM的发生率为1：121,253例妊娠，或1:86,589例活产。整体治愈率100%,没有复发。14例患者行子宫切除术作为一线治疗，治愈率为57.1%。8名患者中有4名（50％）患有转移性痣，做了一线子宫切除术,不用化疗就痊愈了.在所有选择的参数中，两组之间没有统计学上的显着差异。
结论：一线子宫切除术可能会在没有辅助化疗的情况下导致缓解，或减少侵袭性和转移性HM的化疗数量（表。4，图。2，参考。21).
OBJECTIVE: A retrospective analysis of invasive and metastatic hydatidiform moles (HM) in the Slovak Republic (SR)‒epidemiology, patient characteristics and treatment outcomes.
BACKGROUND: Invasive and metastatic mole is a highly curable type of gestational trophoblastic neoplasia. Both invasive and metastatic HM may be cured by hysterectomy without adjuvant chemotherapy.
METHODS: Nineteen cases of histopathologically confirmed HM (10 invasive and 9 metastatic) were treated in SR from 1993 to 2022. Patients were divided into two groups according to treatment modality (hysterectomy only ‒ 8; hysterectomy and chemotherapy ‒ 11). The parameters included in the analysis were patient age, antecedent pregnancy, human chorionic gonadotropin level, tumor size and time to remission.
RESULTS: The incidence of invasive and metastatic HM in the SR was 1:121,253 pregnancies, or 1:86,589 live births. The overall cure rate was 100%, without recurrence. Hysterectomy was performed as first-line therapy in 14 patients, with a cure rate of 57.1%. 4 out of 8 patients (50%) with metastatic moles, who underwent first-line hysterectomy, were cured without chemotherapy. There was no statistically significant difference between the two groups in all selected parameters.
CONCLUSIONS: First-line hysterectomy may lead to remission without adjuvant chemotherapy or reduce the number of chemotherapies in invasive and metastatic HM (Tab. 4, Fig. 2, Ref. 21).
