title: Placental site trophoblastic tumors and epithelioid trophoblastic tumors: Biology, natural history, and treatment modalities.
abstract: Placental site (PSTT) and epithelioid trophoblastic tumor (ETT) are rare types of gestational trophoblastic neoplasia (GTN) that arise from intermediate trophoblast. Given that this cell of origin is different from other forms of GTN, it is not surprising that the clinical presentation, tumor marker profile, and treatment paradigm for PSTT and ETT are quite different as well. The mainstay for therapy for stage I PSTT and ETT is hysterectomy with adjuvant chemotherapy reserved for those presenting greater than four years from the antecedent pregnancy. Surgery is also important for metastatic disease. There is no standardized chemotherapy regimen for advanced stage disease but often consists of a platinum-containing combination therapy, usually EMA-EP or TE/TP. Despite its rarity, PSTT and ETT account for a disproportionate percentage of mortality from GTN likely resulting from their relative chemotherapy resistance. Novel therapeutic modalities therefore are needed to improve the outcomes of women with advanced stage or resistant PSTT and ETT.
authors: New England Trophoblastic Disease Center, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Brigham and Women's Hospital, Dana Farber Cancer Institute, Boston, MA 02115, United States.
authors: Neil S
authors: NS
authors: Horowitz
authors: New England Trophoblastic Disease Center, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Brigham and Women's Hospital, Dana Farber Cancer Institute, Boston, MA 02115, United States.
authors: Donald P
authors: DP
authors: Goldstein
authors: New England Trophoblastic Disease Center, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Brigham and Women's Hospital, Dana Farber Cancer Institute, Boston, MA 02115, United States. Electronic address: rberkowitz@partners.org.
authors: Ross S
authors: RS
authors: Berkowitz
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D007044:Hysterectomy; D011247:Pregnancy; D012307:Risk Factors; D015996:Survival Rate; D018245:Trophoblastic Tumor, Placental Site / Q000175:diagnosis / Q000556:secondary / Q000628:therapy*; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy*
keywords: Epithelioid trophoblastic tumor; Gestational trophoblastic neoplasia; Placental site trophoblastic tumor