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Current Treatment Options in Oncology
Published in: Current Treatment Options in Oncology 10/2017

01-10-2017 | Gynecologic Cancers (LA Cantrell, Section Editor)

Fertility Sparing Strategies in Patients Affected by Placental Site Trophoblastic Tumor

Authors: Benito Chiofalo, MD, Vittorio Palmara, MD, Antonio Simone Laganà, MD, Onofrio Triolo, MD, Salvatore Giovanni Vitale, MD, Francesca Conway, MD, Giuseppe Santoro, MD

Published in: Current Treatment Options in Oncology | Issue 10/2017

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Opinion statement

Placental site trophoblastic tumor (PSTT) is the least common and the most ambiguous gestational trophoblastic tumor. Presentation of PSTT may occur in the course of gestation or from 1 week to 14 years after a normal or an abnormal pregnancy (mole, ectopic pregnancy, abortion). The indicators of aggressive behavior for this tumor are not well established. Due to the rarity of this disease that usually affects women of childbearing potential, we aimed to review the current literature, to identify risk factors and the best conservative therapeutic choices among the cases described. We performed a systematic literature search of articles in English language, published from 1996 to 2017 and indexed in PubMed and Scopus. Based on selective inclusion/exclusion criteria, we considered eight papers eligible for the review. Five were case reports and three were retrospective studies. We extracted and organized data into three different categories depending on the main treatment used. A total of 12 cases were treated with laparotomy; in 5 cases, the treatment was not curative. Therefore, a total abdominal hysterectomy was needed. Five cases were treated successfully with a minimally invasive approach, 2 with uterine evacuation, 2 with hysteroscopic resection, and 1 with a combined hysteroscopic/laparoscopic resection. Only 1 case treated with exclusive chemotherapy proved curative for the patient. Preservation of fertility in PSTT patients of childbearing age should be considered and as showed by the abovementioned studies, is a possible and safe therapeutic choice. Laparotomy for local uterine resection with the modified Strassman approach could be offered in patients at clinical stage 1 that are very motivated to retain fertility, extensively informing the patient of the risks and benefits related to this choice.
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Metadata
Title
Fertility Sparing Strategies in Patients Affected by Placental Site Trophoblastic Tumor
Authors
Benito Chiofalo, MD
Vittorio Palmara, MD
Antonio Simone Laganà, MD
Onofrio Triolo, MD
Salvatore Giovanni Vitale, MD
Francesca Conway, MD
Giuseppe Santoro, MD
Publication date
01-10-2017
Publisher
Springer US
Published in
Current Treatment Options in Oncology / Issue 10/2017
Print ISSN: 1527-2729
Electronic ISSN: 1534-6277
DOI
https://doi.org/10.1007/s11864-017-0502-0

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