Intensified therapies improve survival and identification of novel prognostic factors for placental-site and epithelioid trophoblastic tumours
An updated UK series of placental-site and epithelioid trophoblastic tumours found that more intensive treatment, including high-dose chemotherapy for the worst-prognosis women, improved survival, and refined the factors that predict outcome.
Overview
Retrospective analysis of 125 women with placental-site or epithelioid trophoblastic tumour treated in the UK trophoblastic disease centres, extending the earlier Charing Cross series.
Survival improved in the later period with intensified platinum-based chemotherapy and, for women with an interval of 48 months or more since the antecedent pregnancy, high-dose chemotherapy with stem cell rescue; stage, interval and other factors such as hCG level and metastatic pattern were prognostic.
- Survival improved in the more recent treatment era with intensified therapy.
- Interval of 48 months or more from the antecedent pregnancy remained the dominant adverse factor, with high-dose chemotherapy offering some long-term survivors.
Women with poor-prognosis placental-site or epithelioid trophoblastic tumours should be referred to a specialist centre where intensified and experimental treatments, including immunotherapy, are available.
- Retrospective, with treatment changing over time.
- Small numbers in the high-dose chemotherapy group.
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