Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Cancer Res Treat. 2021 Jul;53(3):874-880. doi: 10.4143/crt.2020.1066. Epub 2020 Dec 7.
The objective of this study was to describe and analyze the clinicopathological features of primary choriocarcinoma (PCC) observed in male patients treated at the Samsung Medical Center between 1996 and 2020.
We reviewed the clinical records of 14 male patients with PCC retrospectively to assess their demographic, histological, and clinical characteristics at the time of diagnosis as well as identify the treatment outcomes.
The median age of the patients was 33 years. The primary tumor site was the testicles in seven cases (50%), the mediastinum in six cases (43%), and the brain in one case (7%). The most common metastatic site was the lungs (79%), followed by the brain (43%). All patients with PCC received cytotoxic chemotherapy. Twelve patients had records of their response to cytotoxic chemotherapy; of these 12 patients, eight (8/12, 67%) achieved an objective response, and four (4/12, 33%) achieved stable disease response as the best response during chemotherapy.
It is known that most male PCC patients eventually develop resistance to cytotoxic chemotherapy and die. Factors such as poor response to chemotherapy, high disease burden, brain metastasis, and hemoptysis at the time of diagnosis are associated with shorter survival time in male PCC patients. Programmed death-1/programmed death-ligand 1 blockade therapy can be a salvage treatment for chemotherapy-resistant male PCC patients.
本研究旨在描述和分析 1996 年至 2020 年期间在三星医疗中心接受治疗的男性原发性绒毛膜癌(PCC)患者的临床病理特征。
我们回顾性分析了 14 例男性 PCC 患者的临床记录,以评估其诊断时的人口统计学、组织学和临床特征,并确定治疗结果。
患者的中位年龄为 33 岁。7 例(50%)原发肿瘤位于睾丸,6 例(43%)位于纵隔,1 例(7%)位于脑部。最常见的转移部位是肺部(79%),其次是脑部(43%)。所有 PCC 患者均接受细胞毒性化疗。12 例患者有细胞毒性化疗反应记录;在这 12 例患者中,8 例(8/12,67%)获得客观缓解,4 例(4/12,33%)在化疗期间获得稳定疾病缓解作为最佳反应。
已知大多数男性 PCC 患者最终对细胞毒性化疗产生耐药性并死亡。化疗反应差、疾病负担高、诊断时脑转移和咯血等因素与男性 PCC 患者的生存时间较短相关。程序性死亡受体-1/程序性死亡配体 1 阻断疗法可能是化疗耐药的男性 PCC 患者的挽救治疗方法。