Placental site trophoblastic tumor: Analysis of presentation, treatment, and outcome Journal Article


Authors: Hyman, D. M.; Bakios, L.; Gualtiere, G.; Carr, C.; Grisham, R. N.; Makker, V.; Sonoda, Y.; Aghajanian, C.; Jewell, E. L.
Article Title: Placental site trophoblastic tumor: Analysis of presentation, treatment, and outcome
Abstract: Objective Placental-site trophoblastic tumor (PSTT) is the rarest form of gestational trophoblastic disease (GTD). A risk-adapted treatment approach has been advocated, but controversy exists as to the most important prognostic markers for this disease. Our goal was to determine the prognostic markers for patients with PSTT seen at our center. Methods We conducted a retrospective analysis of patients with PSTT seen at a single tertiary care center between 1996 and 2011. The association of FIGO stage, interval from antecedent pregnancy, antecedent pregnancy outcome, human chorionic gonadotropin (hCG) level, and age to overall survival was examined using univariate log-rank tests. Presentation, treatment, and outcome were summarized using descriptive statistics. Results Data from 17 patients were analyzed. Eight (47%) had Stage I/II disease and 9 (53%) had Stage III/IV disease. Median overall survival for the entire cohort was 86 months (range, 2-101 months). Median duration of follow-up for surviving patients was 56 months. Increasing FIGO stage (I-III versus IV) was associated with a worse overall survival (p = 0.009). Interval from antecedent pregnancy (≥ 12 months), antecedent pregnancy outcome (full-term), hCG (≥ 1000 IU/L), and age (≥ 40) were not associated with worse survival. Conclusion FIGO stage, specifically Stage IV disease, was the most important predictor of overall survival in our cohort of PSTT patients. © 2012 Elsevier Inc.
Keywords: adult; clinical article; treatment outcome; overall survival; cisplatin; advanced cancer; methotrexate; cancer staging; follow up; etoposide; cyclophosphamide; melphalan; vincristine; autologous stem cell transplantation; cancer survivor; lung metastasis; cancer regression; folinic acid; brain metastasis; dactinomycin; single drug dose; bleomycin; pregnancy; tertiary health care; abdominal mass; abdominal hysterectomy; nephrotic syndrome; placenta; spinal cord metastasis; trophoblastic tumor; chorionic gonadotropin; pregnancy outcome; vagina bleeding; placental site trophoblastic tumor; amenorrhea; spontaneous abortion; wedge resection; salpingectomy; gestational trophoblastic disease; cancer prognosis; gtd; pstt; uterus rupture
Journal Title: Gynecologic Oncology
Volume: 129
Issue: 1
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2013-04-01
Start Page: 58
End Page: 62
Language: English
PROVIDER: scopus
PUBMED: 23274560
DOI: 10.1016/j.ygyno.2012.12.029
DOI/URL:
Notes: --- - "Export Date: 1 May 2013" - "CODEN: GYNOA" - ":doi 10.1016/j.ygyno.2012.12.029" - ": Chemicals/CASbleomycin, 11056-06-7, 9041-93-4; chorionic gonadotropin, 9002-61-3; cisplatin, 15663-27-1, 26035-31-4, 96081-74-2; cyclophosphamide, 50-18-0; dactinomycin, 1402-38-6, 1402-58-0, 50-76-0; etoposide, 33419-42-0; folinic acid, 58-05-9; melphalan, 148-82-3; methotrexate, 15475-56-6, 59-05-2, 7413-34-5; vincristine, 57-22-7" - "Source: Scopus"
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MSK Authors
  1. Vicky Makker
    265 Makker
  2. Elizabeth Jewell
    131 Jewell
  3. Yukio Sonoda
    473 Sonoda
  4. Rachel Nicole Grisham
    170 Grisham
  5. David Hyman
    354 Hyman
  6. Lauren Bakios
    1 Bakios
  7. Christina W Carr
    1 Carr