Retrospective analysis of the clinicopathologic and prognostic characteristics of stage I placental site trophoblastic tumor in China

Abstract

ObjectiveTo investigate clinicopathologic features and identify prognostic factors of placental site trophoblastic tumor (PSTT). MethodsIn a retrospective study, data were analyzed from patients with stage I PSTT treated at a tertiary hospital in Shanghai, China, from January 2007 to May 2013. Univariate log-rank tests were used to examine the association between clinicopathologic characteristics and overall survival and disease-free survival (DFS). ResultsIn total, seven patients had stage I PSTT. Mean age was 31.6years (range 22–42). Four patients had term delivery as the outcome of their antecedent pregnancy. Six had a β-human chorionic gonadotropin (β-hCG) serum concentration of less than 10 000mIU/mL. Among five patients who underwent hysterectomy combined with chemotherapy, one had recurrent disease. One patient received fertility-preserving therapy and achieved complete remission. The mean 5-year overall survival and DFS were 100% and 86%, respectively. Maximum β-HCG concentration of at least 10 000mIU/mL and a mitotic index of more than 5 mitotic counts per 10 high-power fields were associated with disease recurrence (both P=0.014). ConclusionPretreatment β-hCG concentration and mitotic index might be predictors of recurrence among patients with PSTT. Fertility-preserving therapy might be practical in some patients.