The significance of the time interval between antecedent pregnancy and diagnosis of high-risk gestational trophoblastic tumours.
It is thought that the time interval between the antecedent pregnancy and diagnosis of gestational trophoblastic tumours (GTTs) may influence the outcome of these patients. In this study, we investigate the significance of this time interval. Multivariate analysis was used to investigate if the time interval was of prognostic significance from our cohort of 241 high-risk patients with GTT. Subsequent cutpoint analysis was used to determine an optimal cutpoint for the interval covariate. The outcome of these patients was plotted according to the Kaplan-Meier method. The time interval was of prognostic significance on multivariate analysis. A period of greater than 2.8 years after pregnancy was found to be of most significance. The 5-year overall survival was 62.0% (95% CI: 47-76%) for greater than 2.8 years vs 94% (95% CI: 91-97%) for less than 2.8 years (P<0.001). Multivariate analysis showed the presence of liver metastasis and the number of metastasis was also of prognostic importance. The interval between antecedent pregnancy and diagnosis in high-risk GTT is of prognostic significance. This gives some insight into the pathogenesis of the disease.
Powles
T
T
Charing Cross Gestational Trophoblastic Centre, London, UK. tompowles@yahoo.com
Young
A
A
Sanitt
A
A
Sammit
A
A
Stebbing
J
J
Short
D
D
Bower
M
M
Savage
P M
PM
Seckl
M J
MJ
Schmid
P
P
D000293:Adolescent; D000328:Adult; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000175:diagnosis*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D015999:Multivariate Analysis; D011247:Pregnancy; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D014594:Uterine Neoplasms / Q000175:diagnosis*