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Placental Site Trophoblastic Tumors: Analysis of the Clinicopathologic Characteristics of 20 Cases in Korea
  1. Min Chul Choi,
  2. Sang Geun Jung,
  3. Hyun Park,
  4. Won Duk Joo,
  5. Chan Lee,
  6. Je Ho Lee,
  7. Joon Mo Lee,
  8. Yoon Young Hwang and
  9. Seung Jo Kim
  1. * Comprehensive Gynecologic Cancer Center, Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam-si; and
  2. Sangkyung Won Natural Therapy Healing Center, Yeo Ju city, Korea.
  1. Address correspondence and reprint requests to Seung Jo Kim, MD, PhD, Sangkyung Won Natural Therapy Healing Center, Yeo Ju city, Gyeonggi-do, Korea 12619. E-mail: sjkim{at}cha.ac.kr.

Abstract

Objectives The aim of this study was to evaluate the clinicopathologic features of placental site trophoblastic tumors (PSTTs) in Korea.

Methods/Materials Twenty patients given a diagnosis of PSTT in Korea (1990–2013) were evaluated retrospectively, including 14 patients identified through a literature review and 6 patients identified through a medical chart review of a single institution. The analysis included patient age, antecedent pregnancies, time since antecedent pregnancy, presenting symptoms, serum β-human chorionic gonadotropin level, International Federation of Gynecology and Obstetrics stage, treatment, outcome, and follow-up.

Results The mean age of the 20 patients was 32 years (range, 25–53 years). The antecedent pregnancies included 8 term pregnancies, 8 abortions, and 2 molar pregnancies. The time since the antecedent pregnancy was less than 1 year in 16 patients (80%). Nineteen patients (95%) presented with abnormal vaginal spotting or amenorrhea. Serum β-human chorionic gonadotropin levels ranged from normal to 13,480 mIU/mL, although most patients (80%) had a level less than 1000 mIU/mL. Seventeen patients (85%) presented with stage I disease. Ten patients (50%) underwent hysterectomy, and 14 patients (70%) were treated with chemotherapy with or without hysterectomy. In 11 evaluated patients, the median mitotic count index was 3.4 (0.4–10) per 10 high-power fields. The median follow-up time was 17 months (range, 1–68 months). There was no recurrence or death from disease.

Conclusions Korean patients with PSTT often have early-stage disease, which has a favorable prognosis even with fertility-preserving therapy. However, international studies are necessary to determine the optimal treatment and prognostic factors.

  • Placental site trophoblastic tumor
  • Korean
  • Conservative treatment

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Footnotes

  • The authors declare no conflicts of interest.