Prognostic markers and long-term outcome of placental-site trophoblastic tumours: a retrospective observational study
The largest series of this rare trophoblastic tumour showed that women whose tumour appeared four or more years after the causative pregnancy did badly whatever the treatment, and that early-stage disease is cured by hysterectomy alone.
Overview
Retrospective study of 62 women with placental-site trophoblastic tumour treated in the UK trophoblastic disease centres from 1976 to 2006.
Ten-year overall survival was about 70 percent; stage I disease was cured by hysterectomy without chemotherapy, stage II to IV disease required platinum-based chemotherapy (EP/EMA), and an interval of 48 months or more since the antecedent pregnancy was the strongest adverse prognostic factor, with almost no long-term survivors in that group.
- Ten-year overall survival about 70 percent; hysterectomy alone cured stage I disease.
- Interval of 48 months or more from the antecedent pregnancy predicted death from disease regardless of treatment.
Placental-site trophoblastic tumour is managed by hysterectomy for early disease and platinum chemotherapy for advanced disease, and the interval since pregnancy identifies women who need intensified or experimental treatment.
- Retrospective series over thirty years with changing treatments.
- Numbers in the poor-prognosis group were small.
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