Fertility-sparing treatment in patients with placental trophoblastic site tumor: a systematic review.

IF 4.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

International Journal of Gynecological Cancer Pub Date : 2025-06-12 DOI:10.1016/j.ijgc.2025.101972

Alexandros Fotiou, Chrysoula Margioula-Siarkou, Joanna Kacperczyk-Bartnik, Tibor A Zwimpfer, Konstantinos Dinas, Stamatios Petousis

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引用次数: 0

Abstract

Objective: Placental site trophoblastic tumor (PSTT) is a rare pathologic entity of gestational trophoblastic neoplasia. The main objective of the present manuscript is to summarize current evidence regarding the possibility of fertility-sparing management.

Methods: A systematic review of the literature was conducted to evaluate the efficacy, oncological safety, and fertility-preservation outcomes in patients with PSTT undergoing fertility-sparing management. PubMed, Scopus, and Cochrane Library were searched to identify proper articles. Eligibility criteria included all prospective or retrospective cohorts reporting conservative management of PSTT. Primary outcomes were the rate of recurrence and fertility outcome. Secondary outcomes concerned the type of conservative management.

Results: Overall, 16 articles were retrieved including a total of 63 patients. The mean age was 28.3 years (range; 21-37) and the mean serum beta-human chorionic gonadotropin was 17,251.9 IU/L (range; <0.1 to 430,290 IU/L). Regarding the antecedent pregnancy, 41.3% (26 cases) were full-term pregnancies, and 30.2% (19 cases) were abortions. Most cases were International Federation of Gynecology and Obstetrics stage I (73%). The overall recurrence rate of disease was 13.8% (8 of 63 patients) with these patients all treated with hysterectomy after recurrence. There were overall 23 full-term pregnancies reported, indicating a 36.5% fertility rate per patient, while 2 pregnancies are still ongoing at the time of publication.

Conclusions: Fertility-sparing management of patients with PSTT is feasible and oncologically safe, with 36.5% fertility outcomes.

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胎盘滋养层肿瘤患者保留生育能力的治疗：一项系统综述。

目的：胎盘部位滋养细胞瘤是一种罕见的妊娠滋养细胞瘤。本手稿的主要目的是总结目前的证据关于生育节约管理的可能性。方法：系统回顾文献，评估PSTT患者接受保留生育能力治疗的疗效、肿瘤安全性和保留生育能力的结果。检索PubMed， Scopus和Cochrane图书馆以确定合适的文章。入选标准包括所有报告PSTT保守治疗的前瞻性或回顾性队列。主要结局为复发率和生育结局。次要结果涉及保守治疗的类型。结果：共检索到16篇文献，包括63例患者。平均年龄28.3岁(范围；血清β -人绒毛膜促性腺激素平均值为17251.9 IU/L(范围；结论：保留PSTT患者生育能力的管理是可行的，并且在肿瘤上是安全的，生育结局为36.5%。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Gynecological Cancer 医学-妇产科学

CiteScore

6.60

自引率

10.40%

发文量

280

审稿时长

3-6 weeks

期刊介绍： The International Journal of Gynecological Cancer, the official journal of the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology, is the primary educational and informational publication for topics relevant to detection, prevention, diagnosis, and treatment of gynecologic malignancies. IJGC emphasizes a multidisciplinary approach, and includes original research, reviews, and video articles. The audience consists of gynecologists, medical oncologists, radiation oncologists, radiologists, pathologists, and research scientists with a special interest in gynecological oncology.