Alshwayyat Sakhr, Hawa Mahmoud Bashar Abu Al, Maraqa Karam, Alshwayyat Tala Abdulsalam, Alshwayyat Mustafa, Hanifa Hamdah, Alsaghir Tala
King Hussein Cancer Center, Amman, Jordan.
Princess Basma Teaching Hospital, Irbid, Jordan.
Womens Health (Lond). 2025 Jan-Dec;21:17455057251344386. doi: 10.1177/17455057251344386. Epub 2025 Jun 6.
Choriocarcinoma (CC), a rare and aggressive form of cancer, is composed of cytotrophoblasts and syncytiotrophoblasts. It is present in two subtypes: gestational choriocarcinoma (GCC) and non-gestational choriocarcinoma (NGCC). Recognizing the disparities between GCC and NGCC is essential for the precise staging, prognosis, and determination of the primary treatment strategy.
This study aimed to differentiate clinical outcomes, treatment responses, and prognostic factors between GCC and NGCC and to introduce innovative tools for personalized treatment strategies.
A retrospective cohort study with Survival Analysis and Nomogram Development.
We analyzed data from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database and identified female patients diagnosed with GCC and NGCC between 2000 and 2020. The clinicopathological features of each group were compared using the chi-square test. Kaplan-Meier curves, log-rank tests, and Cox proportional hazard regression were used to assess overall survival and cancer-specific survival and to determine risk factors. The 5-year survival predicting nomogram was constructed, evaluated, and validated.
The study included 919 patients with 719 CC and 200 patients with NGCC. The NGCC group was characterized by older age, a higher proportion of married individuals, more advanced disease stages, larger tumor sizes, and a higher frequency of surgical interventions than the GCC group. NGCC was associated with worse survival rates than GCC patients.
This study highlights the critical role of chemotherapy in improving the survival of patients with NGCC, in contrast to its limited effect on GCC. The negative prognosis associated with radiotherapy underscores the urgent need for further investigation to optimize its use. In addition, the introduction of the first web-based survival prediction tool and predictive nomogram marked a significant advancement in personalized treatment strategies, enabling improved clinical outcomes by tailoring therapy to individual patients.
绒毛膜癌（CC）是一种罕见且侵袭性强的癌症，由细胞滋养层细胞和合体滋养层细胞组成。它有两种亚型：妊娠性绒毛膜癌（GCC）和非妊娠性绒毛膜癌（NGCC）。认识到GCC和NGCC之间的差异对于精确分期、预后评估以及确定主要治疗策略至关重要。
本研究旨在区分GCC和NGCC之间的临床结局、治疗反应及预后因素，并引入创新工具以制定个性化治疗策略。
一项采用生存分析和列线图构建的回顾性队列研究。
我们分析了美国国立癌症研究所监测、流行病学和最终结果（SEER）数据库中的数据，确定了2000年至2020年间被诊断为GCC和NGCC的女性患者。使用卡方检验比较每组的临床病理特征。采用Kaplan-Meier曲线、对数秩检验和Cox比例风险回归来评估总生存期和癌症特异性生存期，并确定危险因素。构建、评估和验证了5年生存预测列线图。
该研究纳入了919例患者，其中719例为CC患者，200例为NGCC患者。与GCC组相比，NGCC组的特点是年龄较大、已婚个体比例较高、疾病分期更晚、肿瘤尺寸更大以及手术干预频率更高。NGCC患者的生存率低于GCC患者。
本研究强调了化疗在提高NGCC患者生存率方面的关键作用，而其对GCC的效果有限。放疗相关的不良预后凸显了进一步研究以优化其使用的迫切需求。此外，首个基于网络的生存预测工具和预测列线图的引入标志着个性化治疗策略取得了重大进展，通过为个体患者量身定制治疗方案可改善临床结局。
