title: Placental site trophoblastic tumor: analysis of presentation, treatment, and outcome.
abstract: OBJECTIVE
  Placental-site trophoblastic tumor (PSTT) is the rarest form of gestational trophoblastic disease (GTD). A risk-adapted treatment approach has been advocated, but controversy exists as to the most important prognostic markers for this disease. Our goal was to determine the prognostic markers for patients with PSTT seen at our center.
  
  
  METHODS
  We conducted a retrospective analysis of patients with PSTT seen at a single tertiary care center between 1996 and 2011. The association of FIGO stage, interval from antecedent pregnancy, antecedent pregnancy outcome, human chorionic gonadotropin (hCG) level, and age to overall survival was examined using univariate log-rank tests. Presentation, treatment, and outcome were summarized using descriptive statistics.
  
  
  RESULTS
  Data from 17 patients were analyzed. Eight (47%) had Stage I/II disease and 9 (53%) had Stage III/IV disease. Median overall survival for the entire cohort was 86 months (range, 2-101 months). Median duration of follow-up for surviving patients was 56 months. Increasing FIGO stage (I-III versus IV) was associated with a worse overall survival (p=0.009). Interval from antecedent pregnancy (≥12months), antecedent pregnancy outcome (full-term), hCG (≥1000 IU/L), and age (≥40) were not associated with worse survival.
  
  
  CONCLUSIONS
  FIGO stage, specifically Stage IV disease, was the most important predictor of overall survival in our cohort of PSTT patients.
authors.affiliation: Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Hyman
authors.forename: Lauren
authors.initials: L
authors.lastname: Bakios
authors.forename: Gina
authors.initials: G
authors.lastname: Gualtiere
authors.forename: Christina
authors.initials: C
authors.lastname: Carr
authors.forename: Rachel N
authors.initials: RN
authors.lastname: Grisham
authors.forename: Vicky
authors.initials: V
authors.lastname: Makker
authors.forename: Yukio
authors.initials: Y
authors.lastname: Sonoda
authors.forename: Carol
authors.initials: C
authors.lastname: Aghajanian
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Jewell
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary; D009367:Neoplasm Staging; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D018245:Trophoblastic Tumor, Placental Site / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D014594:Uterine Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy