Intensified therapies improve survival and identification of novel prognostic factors for placental-site and epithelioid trophoblastic tumours

British Journal of Cancer
Fieke E M FroelingM J Seckl

Abstract

Placental-site trophoblastic (PSTT) and epithelioid trophoblastic tumours (ETT) are the rarest malignant forms of gestational trophoblastic disease (GTD). Our prior work demonstrated that an interval of ≥48 months from the antecedent pregnancy was associated with 100% death rate, independent of the stage. Here, we assess whether modified treatments for these patients have increased survival and identify new prognostic factors. The United Kingdom GTD database was screened to identify all PSTT/ETT cases diagnosed between 1973 and 2014. Data and survival outcomes from our prior patient cohort (1976-2006) were compared to our new modern cohort (2007-2014), when intensified treatments were introduced. Of 54,743 GTD patients, 125 (0.23%) were diagnosed with PSTT and/or ETT. Probability of survival at 5 and 10 years following treatment was 80% (95% CI 72.8-87.6%) and 75% (95% CI 66.3-84.3%), respectively. Univariate analysis identified five prognostic factors for reduced overall survival (age, FIGO stage, time since antecedent pregnancy, hCG level, mitotic index) of which stage IV disease (HR 6.18, 95% CI 1.61-23.81, p = 0.008) and interval ≥48 months since antecedent pregnancy (HR 14.57, 95% CI 4.17-50.96, p < 0.001) were most signif...Continue Reading

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Citations

Nov 9, 2018·Archives of Pathology & Laboratory Medicine·Pei Hui
Nov 7, 2019·Journal of the National Comprehensive Cancer Network : JNCCN·Nadeem R Abu-RustumJillian Scavone
Dec 4, 2019·BJOG : an International Journal of Obstetrics and Gynaecology·M M FrijsteinM J Seckl
Oct 12, 2020·BMJ Case Reports·Mariana M ChavesVera Furtado Veiga
Dec 19, 2020·Current Opinion in Obstetrics & Gynecology·James J ClarkMichael J Seckl
Mar 10, 2021·Best Practice & Research. Clinical Obstetrics & Gynaecology·Rosemary A Fisher, Geoffrey J Maher
Jun 14, 2021·Best Practice & Research. Clinical Obstetrics & Gynaecology·Michael J Seckl, Ehsan Ghorani
Nov 4, 2020·Best Practice & Research. Clinical Obstetrics & Gynaecology·Barry W Hancock, John Tidy
Nov 3, 2021·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Mitchell ClarkGeneviève Bouchard-Fortier

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Methods Mentioned

BETA
hysterectomy
X-ray

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