Intermediate trophoblastic tumor: the clinical analysis of 62 cases and prognostic factors

Abstract

Purpose: The aim is to analyze the clinical characteristics of intermediate trophoblastic tumor (ITT).

Methods: 12 cases diagnosed at Qilu Hospital of Shandong University from January 2005 to December 2016 were investigated. Additionally, 50 cases were selected from MEDLINE and CBM databases between January 2010 and December 2016. The clinical data extracted from those aforementioned 62 cases were analyzed.

Results: There were 42 cases with placental site trophoblastic tumor (PSTT), 19 cases with epithelioid trophoblastic tumor (ETT), and 1 case with mixed type (PSTT and ETT). No significant differences were found between PSTT and ETT in terms of age, type of antecedent pregnancy, main complaints, serum β-hCG peak, FIGO stage or prognosis. However, the interval between antecedent pregnancy and the onset was longer in ETT than in PSTT (P = 0.01). FIGO stage was irrelevant to serum β-hCG (P = 0.263). All 62 cases underwent surgeries and seven cases preserved fertility. Fifteen cases with high risk factors were not treated with adjuvant chemotherapy. Univariate analysis results showed that age ≧ 40 years, serum β-hCG peak ≧ 1000 IU/L and nonstandard treatment were associated with poor survival, but only age remained significant on multivariate analysis for ITT (P = 0.018).

Conclusion: PSTT and ETT have similar clinical characteristics generally. Serum β-hCG can not reflect the progress of ITT. Age ≧ 40 years is the independent high risk factor for ITT.

Keywords: Clinical characteristics; Epithelioid trophoblastic tumor; Intermediate trophoblastic tumor; Placental site trophoblastic tumor.