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Outcomes and prognostic factors of placental-site trophoblastic tumor: a retrospective study of 58 cases

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Our goal was to assess the outcomes and explore the prognostic factors for patients with placental-site trophoblastic tumor (PSTT) through this retrospective analysis.

Methods

2043 patients with gestational trophoblastic neoplasia (GTN) were registered at two tertiary hospitals between January 2003 and March 2021, of whom 58 (2.8%) were diagnosed with PSTT. We retrospectively analyzed the clinico-pathological characteristics, treatments, outcomes and prognostic factors.

Results

Only 4 patients died and 5 patients experienced a recurrence. Patients (n = 49) with stage I disease had a favorable prognosis, surgery with (n = 21) or without (n = 28) chemotherapy made no significant difference in overall survival (OS) (p = 0.251) or disease-free survival (DFS) (p = 0.425). 3 patients with stage I had fertility preserving surgery and successful pregnancy was achieved in 2 of them. The outcome of patients with advanced disease was poor. Univariate analysis revealed serum β-hCG levels at diagnosis, FIGO stage IV and metastatic disease were significant predictors of both overall survival and disease-free survival. However, multivariate analysis indicated stage IV was the only significant independent predictor of adverse OS, while metastatic disease was the only significant independent predictor of adverse DFS.

Conclusion

Surgery alone is sufficient for patients with stage I disease without high-risk factors. The prognosis of patients with advanced stage disease remains poor. Stage IV and metastatic disease were the most critical risk factors.

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Acknowledgements

We wish to thank all of the doctors and their patients who have taken part in this study. We would also like to thank the expert pathologists from the two hospitals (Women's Hospital, School of Medicine, Zhejiang University; The First Affiliated Hospital, School of Medicine, Zhejiang University) for their contributions to the diagnosis of PSTT.

Funding

The authors have not disclosed any funding.

Author information

Author notes

  1. Wu Liu and Wei Zhao contributed to the work equally and should be regarded as co-first authors.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, No.1, Xueshi Road, Hangzhou, 310006, China

    Wu Liu & Xiufeng Huang

  2. Department of Obstetrics and Gynecology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

    Wei Zhao

Authors
  1. Wu Liu
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  2. Wei Zhao
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Contributions

WL: Project development, data collection, data analysis, manuscript writing. WZ: project development, data collection, data analysis, manuscript writing. XH: project development, manuscript editing.

Corresponding author

Correspondence to Xiufeng Huang.

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Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethical approval

This study was approved by the Ethics Committee of the two hospitals: Women's Hospital, School of Medicine, Zhejiang University (No. 20210203) and The First Affiliated Hospital, School of Medicine, Zhejiang University (No. 20210486).

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Liu, W., Zhao, W. & Huang, X. Outcomes and prognostic factors of placental-site trophoblastic tumor: a retrospective study of 58 cases. Arch Gynecol Obstet 306, 1633–1641 (2022). https://doi.org/10.1007/s00404-022-06502-7

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  • DOI: https://doi.org/10.1007/s00404-022-06502-7

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