December 18th, 2014

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Title:
Long-term Outcome of Placental Site Trophoblastic Tumor in the Netherlands
Authors:  Nienke E. van Trommel, M.D., Ph.D., Christianne A. R. Lok, M.D., Ph.D., Hans Bulten, M.D., Ph.D., Chris M. G. Thomas, Ph.D., and Leon F. A. G. Massuger, M.D., Ph.D.
  OBJECTIVE: To evaluate the outcome of 16 cases of placental site trophoblastic tumors (PSTTs) treated throughout the Netherlands.

STUDY DESIGN: Patients with PSTT between 1991 and 2009 were identified using the nationwide network and registry of histopathology and cytopathology in the Netherlands (PALGA) and medical records.

RESULTS: Data for 16 patients could be retrieved. The median age of the patients was 32 years. In 7 cases the antecedent pregnancy was a miscarriage and in 6, a term delivery. Clinical data on 3 patients could not be retrieved. Six patients were low-risk according to the International Federation of Gynecology and Obstetrics staging system. The median human chorionic gonadotropin (hCG) level was 46 IU/L, but in 4 patients the hCG level was not elevated. In the majority of patients a hysterectomy was performed, and 5 patients needed additional chemotherapy. There was only 1 recurrence and there were no fatalities.

CONCLUSION: This study emphasizes the need for an international registration. No fatalities were registered. Because of the low incidence and limited experience of general gynecologists with this disease, there is a preference for centralization of all patients with PSTT regardless of their stage.
Keywords:  gestational trophoblastic disease, medical records, placental-site trophoblastic tumor
   
   
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