Retrospective analysis of the clinicopathologic and prognostic characteristics of stage I placental site trophoblastic tumor in China

• Published in: International journal of gynecology and obstetrics 2015-04, Vol.129 (1), p.67-70
• Main Authors: Zheng, Yunxi, Bao, Lingjie, Ning, Yan, Lu, Xin, Hua, Keqin, Yi, Xiaofang
• Format: Article
• Language: English
• Subjects: Adult; Antineoplastic Agents - therapeutic use; China; Chorionic Gonadotropin, beta Subunit, Human - blood; Combined Modality Therapy; Disease-Free Survival; Female; Fertility Preservation; Humans; Hysterectomy; Mitotic Index; Neoplasm Recurrence, Local; Neoplasm Staging; Obstetrics and Gynecology; Placental site trophoblastic tumor; Pregnancy; Pregnancy Outcome; Prognosis; Recurrence; Remission Induction - methods; Retrospective Studies; Trophoblastic Tumor, Placental Site - mortality; Trophoblastic Tumor, Placental Site - pathology; Trophoblastic Tumor, Placental Site - therapy; Uterine Neoplasms - mortality; Uterine Neoplasms - pathology; Uterine Neoplasms - therapy; Young Adult
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1016/j.ijgo.2014.10.027

Abstract Objective To investigate clinicopathologic features and identify prognostic factors of placental site trophoblastic tumor (PSTT). Methods In a retrospective study, data were analyzed from patients with stage I PSTT treated at a tertiary hospital in Shanghai, China, from January 2007 to May 2013. Univariate log-rank tests were used to examine the association between clinicopathologic characteristics and overall survival and disease-free survival (DFS). Results In total, seven patients had stage I PSTT. Mean age was 31.6 years (range 22–42). Four patients had term delivery as the outcome of their antecedent pregnancy. Six had a β-human chorionic gonadotropin (β-hCG) serum concentration of less than 10 000 mIU/mL. Among five patients who underwent hysterectomy combined with chemotherapy, one had recurrent disease. One patient received fertility-preserving therapy and achieved complete remission. The mean 5-year overall survival and DFS were 100% and 86%, respectively. Maximum β-HCG concentration of at least 10 000 mIU/mL and a mitotic index of more than 5 mitotic counts per 10 high-power fields were associated with disease recurrence (both P = 0.014). Conclusion Pretreatment β-hCG concentration and mitotic index might be predictors of recurrence among patients with PSTT. Fertility-preserving therapy might be practical in some patients.