Influence of age as a factor in the outcome of gestational trophoblastic neoplasia.
OBJECTIVE
To question whether older patients have a worse prognosis or poorer outcomes with chemotherapeutic regimens.


METHODS
All gestational trophoblastic disease (GTD) cases registered between January 1986 and September 2006 (n = 8,536) were reviewed and stratified for age. Chi2 analysis was used to ascertain whether significant differences existed with regard to patient age and histologic diagnosis or treatment requirement. Logistic regression analysis was used to predict chemotherapeutic outcomes in patients > 40 years age (n = 50).


RESULTS
An increased relative risk of high-risk pathology and need for treatment in the > 40 years age-group was found. Modification of the World Health Organization risk by removing the age score or altering the age score was significant on univariate analysis but did not actually improve the predictive ability with regard to patient treatment outcomes either with first-line or overall therapy.


CONCLUSIONS
Patient age may not be a risk factor for gestational trophoblastic neoplasia. With birth rates in women > 40 years and maternal age at first pregnancy significantly increasing in the United Kingdom, it is important to improve our understanding of the relationship between GTN and maternal age.
Palmer
Julia E
JE
Department of Gynecological Oncology, Sheffield Teaching Hospitals NHS Trust, and Sheffield Trophoblastic Disease Centre, Sheffield, UK. jupalmer@supanet.com
Hancock
Barry W
BW
Tidy
John A
JA
D000328:Adult; D015331:Cohort Studies; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D008423:Maternal Age; D008875:Middle Aged; D011247:Pregnancy; D012042:Registries; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology