Clinical characteristics and outcomes of placental site trophoblastic tumor: experience of single institution in Korea.
Clinical characteristics and outcomes of placental site trophoblastic tumor: experience of single institution in Korea.
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DOI：
10.5468/ogs.2018.61.3.319
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发表时间：
2018-05-01
影响因子：
--
通讯作者：
Kim, Byoung-Gie
中科院分区：
文献类型：
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作者：
Lee, Hye-Joo;Shin, Wonkyo;Kim, Byoung-Gie
目的：胎盘部位滋养细胞肿瘤（PSTT）是最罕见的妊娠滋养细胞疾病（GTD），最佳治疗方法仍存在争议。在这项研究中，我们分析了在我们机构治疗的连续 6 名 PSTT 患者的临床特征、治疗和结果。 方法：筛选三星医疗中心的电子病历数据库，以识别 1994 年至 2017 年的 PSTT 患者。提取并审查每位患者临床特征和治疗详细信息的病历。本研究经我院机构审查委员会批准。结果：共纳入GTD 418例，PSTT 6例（1.4%）。患者的中位年龄为 31 岁。具有既往妊娠信息的 5 例患者均已足月妊娠，从妊娠到诊断出 PSTT 的中位时间间隔为 8 个月。诊断时血清 β 人绒毛膜促性腺激素 (β-hCG) 的中位滴度为 190.9 mIU/mL。 5 名（83.3%）患者出现不规则阴道流血，1 名（16.7%）患者出现闭经。所有患者在诊断时疾病仅限于子宫，没有转移，仅通过子宫切除术成功治疗。随访期间，所有患者均存活，无疾病。结论：在本研究中，我们观察到，足月妊娠后血清 β-hCG 滴度低、间隔时间不等的不规则阴道出血是 PSTT 最常见的表现特征。此外，我们证明单独子宫切除术可以成功治疗 PSTT I 期疾病。
OBJECTIVE: Placental site trophoblastic tumor (PSTT) is the rarest form of gestational trophoblastic disease (GTD) and the optimum management is still controversial. In this study, we analyzed the clinical features, treatment, and outcomes of 6 consecutive patients with PSTT treated in our institution.METHODS: The electronic medical record database of Samsung Medical Center was screened to identify patients with PSTT from 1994 to 2017. Medical records for the details of each patient's clinical features and treatment were extracted and reviewed. This study was approved Institutional Review Board of our hospital.RESULTS: A total of 418 cases of GTD, 6 (1.4%) patients with PSTT were identified. The median age of the patients was 31 years. The antecedent pregnancy was term in all 5 cases with available antecedent pregnancy information and the median interval from pregnancy to diagnosis of PSTT was 8 months. The median titer of serum beta human chorionic gonadotropin (beta-hCG) at diagnosis was 190.9 mIU/mL. Five (83.3%) patients presented with irregular vaginal bleeding and one (16.7%) had amenorrhea. All patients had disease confined to the uterus without metastasis at diagnosis and were successfully treated by hysterectomy alone. All of them were alive without disease during the follow-up period.CONCLUSION: In this study, we observed low level serum beta-hCG titer and irregular vaginal bleeding with varying interval after antecedent term pregnancy were most common presenting features of PSTT. In addition, we demonstrated hysterectomy alone was successful for the treatment of stage I disease of PSTT.