Demographics, natural history and treatment outcomes of non-molar gestational choriocarcinoma: a UK population study.

Autor: Savage P; Department of Medical Oncology, Trophoblastic Tumour Screening and Treatment Centre, Charing Cross Hospital, Imperial Hospitals NHS Trust, London, UK., Winter M; Sheffield Trophoblastic Disease Centre, Weston Park Cancer Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK., Parker V; Sheffield Trophoblastic Disease Centre, Weston Park Cancer Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK., Harding V; Department of Medical Oncology, Trophoblastic Tumour Screening and Treatment Centre, Charing Cross Hospital, Imperial Hospitals NHS Trust, London, UK., Sita-Lumsden A; Department of Medical Oncology, Trophoblastic Tumour Screening and Treatment Centre, Charing Cross Hospital, Imperial Hospitals NHS Trust, London, UK., Fisher RA; Department of Medical Oncology, Trophoblastic Tumour Screening and Treatment Centre, Charing Cross Hospital, Imperial Hospitals NHS Trust, London, UK., Harvey R; Department of Medical Oncology, Trophoblastic Tumour Screening and Treatment Centre, Charing Cross Hospital, Imperial Hospitals NHS Trust, London, UK., Unsworth N; Department of Medical Oncology, Trophoblastic Tumour Screening and Treatment Centre, Charing Cross Hospital, Imperial Hospitals NHS Trust, London, UK., Sarwar N; Department of Medical Oncology, Trophoblastic Tumour Screening and Treatment Centre, Charing Cross Hospital, Imperial Hospitals NHS Trust, London, UK., Short D; Department of Medical Oncology, Trophoblastic Tumour Screening and Treatment Centre, Charing Cross Hospital, Imperial Hospitals NHS Trust, London, UK., Aguiar X; Department of Medical Oncology, Trophoblastic Tumour Screening and Treatment Centre, Charing Cross Hospital, Imperial Hospitals NHS Trust, London, UK., Tidy J; Sheffield Trophoblastic Disease Centre, Weston Park Cancer Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK., Hancock B; Sheffield Trophoblastic Disease Centre, Weston Park Cancer Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK., Coleman R; Sheffield Trophoblastic Disease Centre, Weston Park Cancer Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK., Seckl MJ; Department of Medical Oncology, Trophoblastic Tumour Screening and Treatment Centre, Charing Cross Hospital, Imperial Hospitals NHS Trust, London, UK.
Jazyk: angličtina
Zdroj: BJOG : an international journal of obstetrics and gynaecology [BJOG] 2020 Aug; Vol. 127 (9), pp. 1102-1107. Date of Electronic Publication: 2020 Apr 03.
DOI: 10.1111/1471-0528.16202
Abstrakt: Objective: To investigate the demographics, natural history and treatment outcomes of non-molar gestational choriocarcinoma.
Design: A retrospective national population-based study.
Setting: UK 1995-2015.
Population: A total of 234 women with a diagnosis of gestational choriocarcinoma, in the absence of a prior molar pregnancy, managed at the UKs two gestational trophoblast centres in London and Sheffield.
Methods: Retrospective review of the patient's demographic and clinical data. Comparison with contemporary UK birth and pregnancy statistics.
Main Outcomes: Incidence statistics for non-molar choriocarcinoma across the maternal age groups. Cure rates for patients by FIGO prognostic score group.
Results: Over the 21-year study period, there were 234 cases of non-molar gestational choriocarcinoma, giving an incidence of 1:66 775 relative to live births and 1:84 226 to viable pregnancies. For women aged under 20, the incidence relative to viable pregnancies was 1:223 494, for ages 30-34, 1:80 227, and for ages 40-45, 1:41 718. Treatment outcomes indicated an overall 94.4% cure rate. Divided by FIGO prognostic groups, the cure rates were low-risk group 100%, high-risk group 96% and ultra-high-risk group 80.5%.
Conclusions: Non-molar gestational choriocarcinoma is a very rare diagnosis with little prior detailed information on the demographics and natural history. The data in this study give age-related incidence data based on a large national population study. The results also demonstrated the widely varying natural history of this rare malignancy and the marked correlation of disease incidence with rising maternal age.
Tweetable Abstract: National gestational choriocarcinoma database indicates a close association between increasing maternal age and incidence.
(© 2020 Royal College of Obstetricians and Gynaecologists.)
Databáze: MEDLINE
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