CHORIOCARCINOMA FOLLOWING TERM PREGNANCY

1 January 1979

journal article
research article

Vol. 53 (2) , 207-212

Abstract

Patients (265) with malignant trophoblastic disease were admitted between July 1966 and June 1976. Of these 265 patients, 20 had choriocarcinoma following a term gestation with a survival rate of 60% as compared to 95% survival rate for the remaining 245 patients. Previously described risk factors of initial human chorionic gonadotropin (hCG) titer of > 100,000 IU/24 h urine, duration of symptoms for more than 4 mo., significant prior unsuccessful chemotherapy or cerebral or hepatic metastases identified the poor prognosis group. Post-term gestation poor prognosis patients had a significantly lower cure rate (47%) than other patients with poor prognosis for gestational trophoblastic disease (75%; P < 0.05). Post-term gestation choriocarcinoma has a propensity for more extensive metastatic spread and would appear to be less responsive to conventional chemotherapy, which may be due to an altered immune response in these patients. An antecedent term pregnancy should be added to the previously described high-risk factors for patients with malignant trophoblastic disease.

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