Taran Florin-Andrei, Wosnik Annette, Juhasz-Böss Ingolf, Burtscher Katrin, Morakis Philipp
Department of Obstetrics and Gynecology, Medical Centre, University of Freiburg, Freiburg, Germany.
Department of Gynecology and Gynecologic Oncology, Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, Medical Faculty and University Clinic of Cologne, University of Cologne, Cologne, Germany.
Arch Gynecol Obstet. 2025 May 5. doi: 10.1007/s00404-025-08038-y.
Choriocarcinoma is a rare tumour. In Germany, due to its low incidence and lack of centralisation in care, only limited data are available on real-world clinical practice. This study aims to analyse tumour characteristics, treatment, and outcomes of patients with gestational choriocarcinoma using data from the Baden-Wuerttemberg Cancer Registry (BWCR), Germany.
We included patients aged 18-50 years diagnosed with choriocarcinoma between 2015 and 2023, reported to the BWCR. The cases were identified using ICD-O-3 codes 9100/3, 9101/3 and ICD-10-GM code C58.9. Diagnostic and treatment information was derived from standardised registry entries and pathology reports. First-line treatment was defined as therapy initiated within 120 days of diagnosis. Data were analysed using descriptive statistics.
38 patients (mean age 33.4 years) were included; 39% presented with metastatic disease, predominantly isolated lung metastases (67%). Systemic therapy was reported in 28 cases: MTX (n = 10), EMA-CO (n = 12), and - due to timecourse or substance - other regimens (n = 6). The reported treatment duration ranged from 20 - 120 days (MTX) and 50 -154 days (EMA-CO). One MTX-treated patient (10%) required escalation to EMA-CO. Among EMA-CO cases, therapy was discontinued in three patients and one second-line treatment reported. The reported adverse events were in line with published data.
This population-based analysis provides real-world insights into choriocarcinoma care in Baden-Wuerttemberg. While outcomes align with current guidelines, observed resistance to MTX and EMA-CO highlights the need for individualised treatment and closer monitoring. These findings underline the value of registry data in guiding therapy optimization-even in rare diseases like choriocarcinoma.
绒毛膜癌是一种罕见肿瘤。在德国,由于其发病率低且治疗缺乏集中化,关于实际临床实践的可用数据有限。本研究旨在利用德国巴登 - 符腾堡州癌症登记处(BWCR)的数据,分析妊娠绒毛膜癌患者的肿瘤特征、治疗及预后情况。
我们纳入了2015年至2023年间向BWCR报告的、年龄在18 - 50岁之间被诊断为绒毛膜癌的患者。病例通过ICD - O - 3编码9100/3、9101/3和ICD - 10 - GM编码C58.9进行识别。诊断和治疗信息来自标准化的登记条目和病理报告。一线治疗定义为在诊断后120天内开始的治疗。数据采用描述性统计进行分析。
共纳入38例患者(平均年龄33.4岁);39%的患者出现转移性疾病,主要为孤立性肺转移(67%)。28例患者报告了全身治疗情况:甲氨蝶呤(MTX,n = 10)、EMA - CO方案((n = 12),以及由于时间进程或药物原因采用的其他方案(n = 6)。报告的治疗持续时间为20 - 120天(MTX)和50 - 154天(EMA - CO)。1例接受MTX治疗的患者(10%)需要升级至EMA - CO方案。在EMA - CO方案治疗的病例中,3例患者停止治疗,1例报告接受二线治疗。报告的不良事件与已发表数据一致。
这项基于人群的分析为巴登 - 符腾堡州绒毛膜癌的治疗提供了实际情况的见解。虽然预后与当前指南一致,但观察到的对MTX和EMA - CO的耐药性凸显了个体化治疗和密切监测的必要性。这些发现强调了登记数据在指导治疗优化方面的价值——即使是在绒毛膜癌这样的罕见疾病中。