The clinical characteristics and prognostic analysis of 35 postterm choriocarcinomas.

OBJECTIVE

Postterm choriocarcinoma is rare and seldom reported. Patients with postterm choriocarcinoma have unfavorable outcomes. Thus, we conducted a retrospective study to better understand this disease.

METHODS

Thirty-five patients with postterm choriocarcinoma who received treatment at West China Second University Hospital from January 2011 to August 2022 were enrolled.

RESULTS

The most common symptom in our cohort was abnormal uterine bleeding (25/35, 71.4%). Interval to diagnosis, serum β-hCG, and FIGO score or FIGO stage were not related to recurrence (P = 0.523, P = 0.812, P = 0.343, P = 0.440). However, the number of chemotherapy courses before achieving normal β-hCG (crude hazard ratio [HR] [95% confidence interval [CI]: 1.15 [1.04-1.26], P = 0.007) was positively related to recurrence, while the number of consolidation chemotherapy courses was negatively related to recurrence (crude HR [95% CI]: 0.51 [0.30-0.88], P = 0.015). Patients who received EMA-CO had a lower risk of recurrence, but the difference was not statistically significant (crude HR [95% CI]: 0.41 [0.08-2.06], P = 0.281). Patients who received other regimens (other than EMA-CO or 5-FU + Act-D) had a significantly higher risk of recurrence (crude HR [95% CI]: 8.30 [1.61-42.78], P = 0.011).

CONCLUSIONS

The complete remission rate of postterm choriocarcinoma was 88.6% in our study. Serum β-hCG surveillance and/or pathological examination of curettage might lead to an earlier diagnosis. The number of consolidation chemotherapy courses was negatively related to recurrence.

CLINICAL TRIAL NUMBER

Not applicable.