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. 2022 Jul 29;101(30):e29934.
doi: 10.1097/MD.0000000000029934.

Clinical features and management of trophoblastic epithelioid tumors: A systematic review

Florin Gorun  1 , Larisa Tomescu  1 , Andrei Motoc  2 , Cosmin Citu  1 , Ioan Sas  1 , Denis Mihai Serban  1 , Marius Forga  1 , Ioana Mihaela Citu  3 , Oana Maria Gorun  4
Affiliations

Clinical features and management of trophoblastic epithelioid tumors: A systematic review

Florin Gorun et al. Medicine (Baltimore). .

Abstract

Background: This study aimed to systematically review the existing literature on epithelioid trophoblastic tumors (ETTs), the rarest type of gestational trophoblastic neoplasia.

Methods: A systematic review according to PRISMA guidelines was performed, using ScienceDirect, Web of Science, and Scopus databases. The only filter used was the English language. Eligibility/inclusion criteria: retrospective observational studies (case reports, case series) including full case description of epithelioid trophoblastic tumor lesions.

Results: Seventy studies were assessed for synthesis, including 147 cases. 66.7% of patients with ETT presented with irregular vaginal bleeding. Pretreatment β-hCG levels ranged up to 1000 mIU/mL in 58.5% patients. Of most patients, 42.2% had stage I disease, 10.9% stage II, 25.2% stage III, and 21.8% of patients had stage IV. The most common sites of metastatic disease were the lungs, followed by the liver and brain. After treatment, complete remission was achieved in 75.5% of patients, partial remission in 10.2% of patients, and 14.3% of patients died. On univariate and multivariate analyses, stage IV disease was an independent prognostic factor for overall and disease-free survival.

Conclusions: Hysterectomy and metastatic lesion resection are essential for controlling ETT. Investigational studies on molecules like EGFR, VEGF, PD-1, CD105, and LPCAT1 are potential therapeutic targets for metastatic ETT.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Flowchart of literature review.
Figure 2.
Figure 2.
Cumulative survival in women with ETT, depending on FIGO stage of the disease. ETT = epithelioid trophoblastic tumor.
Figure 3.
Figure 3.
Cumulative survival in women with ETT, depending on the time between previous pregnancy and the onset of the disease. ETT = epithelioid trophoblastic tumor.
See this image and copyright information in PMC

References

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