ÚPMD / CTN

Department Head

doc. MUDr. Miloš Zavadil, DrSc.
telefon: 296 511 595, 296 511 111, fax: 296 511 296
e-mail: zavadilctn@upmd.cz

Description of activity

CTN is the only one accredited workplace in the Czech Republic, which concentrates all malignant, potentially malignant and complicated forms of trophoblastic disease from all of Czech Republic. According to the public report of the Ministry of Health from 1976 to 1999 diagnosis, treatment and followed up care was provided. The department registers the incidence of trophoblastic disease in Czech Republic and administrates the epidemiological database of malignant and benign forms of trophoblastic disease. It a scientific research reference center for trophoblastic disease in the Czech Republic and provides consultation to all gynecological and pathological anatomy workplaces in the Czech Republic.

Structure

The following UPMD workplaces participate in the activity of CTN:

• Outpatient department, in patient (Gynecology 3, eventually Gynecology 2) Operating room, Internal department, Ultrasound, X-Ray, Histopathology, Biochemistry, Hematology, Molecular genetic.

In special cases, CTN cooperates with:

• Computed tomography of the 3^rd medical faculty of Charles University, the 3^rd Surgical clinic of the 2^nd Medical faculty, and the surgical clinic of the first medical faculty of Charles University in Prague. Gamma knife in Homolka hospital, and positron emission tomography in Homolka hospital.

Service:

The duty of CTN is provided by doctors, nurses, and laboratory workers at UPMD with a long term experience in assessing these problems. The head physician MUDr. Petr Safar, CSc., head of department G3, MUDr. Martin Pan, MUDr. Radek Turyna, head nurse Eva Novozamska and the nurses of G3 work together with acute care doctors and nurses. (acute care line: 296 511 365)

Admission and intake of patients into CTN is possible 24 hours daily. Special CTN ambulance and controls are every Tuesday from 8-12 o:clock.

Results:

The processing of clinical, bioptic, and laboratory findings with 378 cases of choriocarcinoma, 220 proliferative moles, and 1670 complete and partial hydatiform moles, 430 persistent trophoblastic invasions and more than 2500 trophoblastic invasions enabled us to elaborate and implicate a national classification of trophoblastic disease from the year 1972.

A similar classification compatible with ours was proposed by the WHO in 1983. Current results are published in our and also foreign literature. 44 works where cited and discussed at a series of centers. (England, USA, Canada, Mexico, Austria, and Germany)

In the first years after the foundation of CTN, choriocarcinoma was the cancer that killed almost 100% in the first several months. Since the 80's of the last century, we have been able to treat the majority of our patients (mainly with the help of chemotherapy) and also retaining the ability to have children. So choriocarcinoma has become the first human cancer which can be treated even when generalized. (dispersion of cancer in more organs)

What is trophoblastic disease-who does it affect?

Trophoblastic disease originates in women in pregnancy, in which there exists a malignant tumor in the placental bed (placenta is formed with trophoblastic tissue) so-called choriocarcinoma or there evolving changes in the placenta of which choriocarcinoma can develop. Different forms of hydatiform mole, when the placenta is morbidly changing into a formation similar to grapes and so called trophoblastic invasion, a process that anchors the placenta to the uterus and therefore is presented in each pregnancy.

The optimal diagnosis and treatment insures the concentration of these ill patients into specialized centers. For this reason we established the national center for trophoblastic disease in 1955. A similar center was established in England and USA at that time.