Vaginal metastasis in gestational trophoblastic neoplasia: Experience from Sheffield trophoblastic disease Centre and recommendations for management.

Introduction: Gestational trophoblastic neoplasia (GTN) is rare in the UK, with an estimated incidence of one in 50,000 live births. Cases of vaginal metastasis are even rarer, with only eight case series reporting 187 cases over the past 40 years. Management recommendations in the literature are scarce despite the potential risk of massive, potentially life-threatening vaginal haemorrhage.

Patients' experience of menopausal symptoms post-chemotherapy treatment for gestational trophoblastic neoplasia.

Purpose: We aimed to explore patient's experience of chemotherapy-induced menopausal symptoms; to ascertain how patients tried to alleviate their symptoms and how health professionals supported them in order to identify current unmet needs.

Methods: We designed a retrospective cross-sectional exploratory study of a sample of 11 women who received multi-agent combination chemotherapy for Gestational Trophoblastic Neoplasia. Postal surveys using the Greene Climacteric Scale (GCS) questionnaire followed up by semi-structured telephone interviews were used.

High HIV prevalence in gestational trophoblastic neoplasia patients.

Objective: To assess the HIV prevalence in patients diagnosed with gestational trophoblastic neoplasia (GTN).

Design: A retrospective single centre cohort study.

Methods: A database from the Sheffield Trophoblastic Disease Centre (STDC), Sheffield, UK was searched between 1st January 2015 and 31st December 2021.

Gestational Trophoblastic Disease: Best Practice Nursing Guidelines.

Background: Clinical outcomes in gestational trophoblastic disease (GTD) are generally excellent, but GTD is a rare and complex condition that requires specialist information and support to offer a gold standard of care. Across Europe, specialist nurses and/or midwives are increasingly common in the GTD multidisciplinary team to work alongside medical professionals in a holistic model of care; however, the role is sometimes non-existent or can vary significantly between GTD centres.

Objectives: The aim of the European Organisation for Treatment of Trophoblastic Diseases' (EOTTD) is to harmonise best practice in Europe.

Placental site trophoblastic tumour and epithelioid trophoblastic tumour.

Placental site trophoblastic tumour (PSTT) and epithelioid trophoblastic tumour (ETT) are the rarest subtypes of gestational trophoblastic disease (GTD). Their diagnosis is complicated and lacks specific and sensitive tumour markers. They are slow-growing tumours and can occur months to years after any type of antecedent pregnancy.

Demographics, natural history and treatment outcomes of non-molar gestational choriocarcinoma: a UK population study.

Objective: To investigate the demographics, natural history and treatment outcomes of non-molar gestational choriocarcinoma.

Design: A retrospective national population-based study.

Setting: UK 1995-2015.

When to stop human chorionic gonadotrophin (hCG) surveillance after treatment with chemotherapy for gestational trophoblastic neoplasia (GTN): A national analysis on over 4,000 patients.

Objective: To determine the optimal duration of human chorionic gonadotrophin (hCG) surveillance following treatment for low and high risk gestational trophoblastic neoplasia (GTN) and establish whether the current surveillance protocol that recommends life-long hCG monitoring requires revision.

Methods: A population-based cohort study was undertaken using a national registry, comprising patients from both tertiary trophoblastic disease treatment units in the UK (London and Sheffield). All patients who received chemotherapy for low or high risk GTN in the UK between 1958 and 2014 in London and 1973 and 2015 in Sheffield (n = 4201) were included in the study.

The results of treatment with high-dose chemotherapy and peripheral blood stem cell support for gestational trophoblastic neoplasia.

Objective: The objective of the study was to evaluate the effect of high-dose chemotherapy (HDC) with peripheral blood stem cell support (PBSCS) on survival of patients with gestational trophoblastic neoplasia (GTN) with either refractory choriocarcinomas or a poor-prognosis placental site/epithelioid trophoblastic tumours (PSTT/ETTs).

Methods: Databases of two referral centres for gestational trophoblastic disease were searched, and 32 patients treated with HDC between 1994 and 2015 were identified. Tissue samples were retrieved for genetic evaluation.

Healthy women with persistently elevated hCG levels: a case series of fourteen women.

Objective: To review our own data and that in the literature in order to assess likely morbidity and mortality risks and enhance the information that we can provide to patients suffering with this condition.

Study Design: This was a retrospective case series using data from the Sheffield Trophoblastic Disease Centre Database combined with data from prior publications.

Results: A diagnosis of elevated human chorionic gonadotropin (hCG) in an otherwise healthy woman carries an 11-19% risk of malignancy and 1-3% risk of mortality.

Impact of the revised FIGO/WHO system on the management of patients with gestational trophoblastic neoplasia.

Objective: To study the effect of a change in disease scoring systems on the management of patients with gestational trophoblastic neoplasia (GTN) in our supra-regional treatment centre.

Methods: We reviewed disease characteristics and treatment outcomes in 632 GTN patients managed at our centre from 1973 to 2006. Two disease scoring systems were used sequentially, the Sheffield modification of the Charing Cross Scoring System (SCCSS) before 2000, and the revised FIGO/modified WHO system (FIGO 2000) thereafter.

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.

Study Design: 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.

Epithelioid trophoblastic tumor: a review of the literature.

Objective: To identify common characteristics and provide suggestions for future reporting and management of epithelioid trophoblastic tumors (ETTs).

Study Design: Definitions and treatment strategies are unclear because of low incidence and paucity of reported data. Literature search revealed 52 cases of ETT; 67% presented with abnormal vaginal bleeding, 36% had prior evidence of molar pregnancy and 35% presented with metastases.