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Fertility-Preserving Treatment in Young Patients With Placental Site Trophoblastic Tumors
  1. Xiaoyan Shen, MD*,
  2. Yang Xiang, MD*,
  3. Lina Guo, MD,
  4. Fengzhi Feng, MD*,
  5. Xirun Wan, MD*,
  6. Yu Xiao, MD,
  7. Jun Zhao, MD* and
  8. Tong Ren, MD*
  1. *Departments of Obstetrics and Gynecology, and
  2. Departments of Pathology, Peking Union Medical College Hospital, Beijing, People’Departments of s Republic of China.
  1. Address correspondence and reprint requests to Tong Ren, MD, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1. Dongchen District, Beijing 100730, PR China. E-mail: rentong89@163.com.

Abstract

Objective To investigate the methods of fertility-sparing therapy for patients with placental site trophoblastic tumor (PSTT) and analyze the outcomes.

Methods From January 1999 to October 2010, the clinical features, pathology, diagnosis, fertility-preserving treatment, and outcomes of 6 patients with PSTT were studied retrospectively. Six patients were provided with multimodality treatment, which combined with surgery and chemotherapy. Five patients had received intrauterine arterial infusion chemotherapy. Three patients with polypoid-type tumor were treated by dilation and curettage and combination chemotherapy. Three patients with nodular masses underwent uterine tumor resection and combination chemotherapy. Two patients with nodular masses were treated by combination chemotherapy after dilation and curettage, and then uterine tumor resection was performed.

Results After follow-up for 10 to 104 months (mean, 47 months), 6 patients achieved a complete remission, presented no signs of recurrence, and had restored normal menstruation. One of them had a normal delivery in July 2011.

Conclusions Fertility-conserving therapy for young women with PSTT would be practicable if the patient is younger than 35 years, strongly desires to preserve fertility and responds well to chemotherapy and conservative surgery, the pathological results of which do not show poor prognostic factors and the gross pathologic type does not present markedly enlarged uterus, diffuse infiltrative and diffuse multifocal disease within the uterus.

  • Gestational trophoblastic tumors
  • Intermediate trophoblastic tumor
  • Placental site trophoblastic tumor
  • Fertility preservation
  • Therapy

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Footnotes

  • This study was financially supported by the Key Projects in the National Science and Technology Pillar Program during the 11th 5-year plan period of China (No. 2008BAI57B05).

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