Demographics, natural history and treatment outcomes of non‐molar gestational choriocarcinoma: a UK population study

Savage, Philip; Winter, M.C.; Parker, Victoria L; Harding, Victoria; Sita‐Lumsden, Ailsa; Fisher, Rosemary A.; Harvey, Richard A.; Unsworth, Nicholas; Sarwar, Naveed; Short, Dee; Aguiar, Xianne; Tidy, John; Hancock, Barry W.; Coleman, Robert E.; Seckl, Michael J.

doi:10.1111/1471-0528.16202

Cited by 19 publications

(26 citation statements)

References 22 publications

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“…The incidence of choriocarcinoma is approximately 3 per 100,000 deliveries in Europe and North America, compared to approximately 23 per 100,000 in Southeast Asia [3,9]. This risk increases with increasing maternal age [10].…”

Section: Epidemiologymentioning

confidence: 99%

“…Women aged 40-49 with initial hCG levels exceeding 175,000 mIU/mL represent an especially at risk group, with 85% developing post-evacuation GTN [38]. In women older than 50 years, the risk of post-evacuation GTN may be as high as 60%, regardless of presenting hCG level [39], though population based studies place this risk for older women around 30% [10]. For these women, or for those in whom reliable hCG follow up cannot be obtained, hysterectomy should be considered [39][40][41].…”

Section: Molar Pregnancymentioning

confidence: 99%

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Epidemiology, diagnosis, and treatment of gestational trophoblastic disease: A Society of Gynecologic Oncology evidenced-based review and recommendation

Horowitz

Eskander

Adelman

et al. 2021

Gynecologic Oncology

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Section: Epidemiologymentioning

confidence: 99%

Section: Molar Pregnancymentioning

confidence: 99%

Epidemiology, diagnosis, and treatment of gestational trophoblastic disease: A Society of Gynecologic Oncology evidenced-based review and recommendation

Horowitz

Eskander

Adelman

et al. 2021

Gynecologic Oncology

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“…Choriocarcinoma is the most common type of GTN and can occur in association with any pregnancy events, such as molar pregnancy and nonmolar events (eg, term pregnancy, pre-term pregnancy, abortion). 1 The incidence of choriocarcinoma in association with nonmolar pregnancy is one in every 66,775 births. The most common sites of GTN metastasis are the lungs (80%), vagina (30%), pelvis (20%), liver (10%), and brain (10%).…”

Section: Clinical Discussionmentioning

confidence: 99%

A Pregnant Woman With Hemoptysis and Diffuse Pulmonary Nodules

Pervaiz

Inany

Nguyen

et al. 2021

Chest

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A 22-year-old woman who was 36 weeks pregnant presented with a 4-day history of cough, hemoptysis, and exertional dyspnea. She had no fever, night sweats, or weight loss. The review of system was otherwise negative. Her medical history was notable for a spontaneous first-trimester abortion a year ago. At that time, she had a transvaginal ultrasound scan that showed a gestational sac with no fetal movement. A post-abortion ultrasound scan revealed no residual fetal parts.

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“…However, while it is well known that choriocarcinoma can derive from 2-3% of hydatidiform moles, the driving causes of this phenomenon remain unknown [4,5]. More rarely, choriocarcinoma may also develop after a normal pregnancy, with an incidence of 1 per 67,000 live births [6]. Choriocarcinoma following normal pregnancies are generally more severe and associated with an increased mortality compared to those arising from hydatidiform moles, but the determinants of its aggressiveness were poorly investigated [7].…”

Section: Introductionmentioning

confidence: 99%

Transcriptomic Characterization of Postmolar Gestational Choriocarcinoma

et al. 2021

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The human placenta shares properties with solid tumors, such as rapid growth, tissue invasion, cell migration, angiogenesis, and immune evasion. However, the mechanisms that drive the evolution from premalignant proliferative placental diseases—called hydatidiform moles—to their malignant counterparts, gestational choriocarcinoma, as well as the factors underlying the increased aggressiveness of choriocarcinoma arising after term delivery compared to those developing from hydatidiform moles, are unknown. Using a 730-gene panel covering 13 cancer-associated canonical pathways, we compared the transcriptomic profiles of complete moles to those of postmolar choriocarcinoma samples and those of postmolar to post-term delivery choriocarcinoma. We identified 33 genes differentially expressed between complete moles and postmolar choriocarcinoma, which revealed TGF-β pathway dysregulation. We found the strong expression of SALL4, an upstream regulator of TGF-β, in postmolar choriocarcinoma, compared to moles, in which its expression was almost null. Finally, there were no differentially expressed genes between postmolar and post-term delivery choriocarcinoma samples. To conclude, the TGF-β pathway appears to be a crucial step in the progression of placental malignancies. Further studies should investigate the value of TGF- β family members as biomarkers and new therapeutic targets.

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Demographics, natural history and treatment outcomes of non‐molar gestational choriocarcinoma: a UK population study

Abstract: Objective To investigate the demographics, natural history and treatment outcomes of non-molar gestational choriocarcinoma. Design A retrospective national population-based study.

Cited by 19 publications

References 22 publications

Epidemiology, diagnosis, and treatment of gestational trophoblastic disease: A Society of Gynecologic Oncology evidenced-based review and recommendation

Epidemiology, diagnosis, and treatment of gestational trophoblastic disease: A Society of Gynecologic Oncology evidenced-based review and recommendation

A Pregnant Woman With Hemoptysis and Diffuse Pulmonary Nodules

Transcriptomic Characterization of Postmolar Gestational Choriocarcinoma

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