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Fertility Sparing Strategies in Patients Affected by Placental Site Trophoblastic Tumor

  • Gynecologic Cancers (LA Cantrell, Section Editor)
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

Placental site trophoblastic tumor (PSTT) is the least common and the most ambiguous gestational trophoblastic tumor. Presentation of PSTT may occur in the course of gestation or from 1 week to 14 years after a normal or an abnormal pregnancy (mole, ectopic pregnancy, abortion). The indicators of aggressive behavior for this tumor are not well established. Due to the rarity of this disease that usually affects women of childbearing potential, we aimed to review the current literature, to identify risk factors and the best conservative therapeutic choices among the cases described. We performed a systematic literature search of articles in English language, published from 1996 to 2017 and indexed in PubMed and Scopus. Based on selective inclusion/exclusion criteria, we considered eight papers eligible for the review. Five were case reports and three were retrospective studies. We extracted and organized data into three different categories depending on the main treatment used. A total of 12 cases were treated with laparotomy; in 5 cases, the treatment was not curative. Therefore, a total abdominal hysterectomy was needed. Five cases were treated successfully with a minimally invasive approach, 2 with uterine evacuation, 2 with hysteroscopic resection, and 1 with a combined hysteroscopic/laparoscopic resection. Only 1 case treated with exclusive chemotherapy proved curative for the patient. Preservation of fertility in PSTT patients of childbearing age should be considered and as showed by the abovementioned studies, is a possible and safe therapeutic choice. Laparotomy for local uterine resection with the modified Strassman approach could be offered in patients at clinical stage 1 that are very motivated to retain fertility, extensively informing the patient of the risks and benefits related to this choice.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Authors and Affiliations

  1. Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy

    Benito Chiofalo MD, Vittorio Palmara MD, Antonio Simone Laganà MD, Onofrio Triolo MD & Salvatore Giovanni Vitale MD

  2. Department of Biomedicine and Prevention, Section of Gynecology and Obstetrics, University of Rome Tor Vergata, Rome, Italy

    Francesca Conway MD

  3. Department of Biomedical and Dental Sciences and Morpho-Functional Images, University of Messina, 1st floor Biologic Tower, Messina, Italy

    Giuseppe Santoro MD

  4. Department of Biomedical and Dental Sciences and Morpho-Functional Images, A.O.U. Policlinic “G. Martino”, 1st floor Biologic Tower, Via Consolare Valeria, 98125, Messina, Italy

    Giuseppe Santoro MD

Authors
  1. Benito Chiofalo MD
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  2. Vittorio Palmara MD
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  3. Antonio Simone Laganà MD
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  4. Onofrio Triolo MD
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  5. Salvatore Giovanni Vitale MD
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  6. Francesca Conway MD
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  7. Giuseppe Santoro MD
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Corresponding author

Correspondence to Giuseppe Santoro MD.

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Conflict of Interest

Benito Chiofalo, Vittorio Palmara, Antonio Simone Laganà, Onofrio Triolo, Salvatore Giovanni Vitale, Francesca Conway, and Giuseppe Santoro declare they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Gynecologic Cancers

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Chiofalo, B., Palmara, V., Laganà, A.S. et al. Fertility Sparing Strategies in Patients Affected by Placental Site Trophoblastic Tumor. Curr. Treat. Options in Oncol. 18, 58 (2017). https://doi.org/10.1007/s11864-017-0502-0

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  • DOI: https://doi.org/10.1007/s11864-017-0502-0

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