Curability of MalignatTrophoblastic Tumours: Dependence on Histological Type and RiskGrades

Authors: M. Zavadil;  J. Feyereisel;  P. Šafář;  M. Pán;  H. Heřman
Authors‘ workplace: Centrum pro trofoblastickou nemoc (CTN), vedoucí doc. MUDr. M. Zavadil, DrSc. Ústav pro péči o matku a dítě, ředitel doc. MUDr. J. Feyereisl CSc. Katedra gynekologie-porodnictví IPVZ Praha, vedoucí doc. MUDr. J. Feyereisel, CSc.
Published in: Čes. Gynek.2001, , č. 6 s. 422-426


Curability of malignant trophoblastic tumours.Design: Retrospective analysis.Setting: Trophoblastic Disease Centre (TDC-CZ) in the Czech Republic.Methods: Clinical and pathological analysis of 367 malignant trophoblastic tumours (MTT) fromthe point of histologic typing, risk degrees (RD) according to classification of FIGO, WHO, NIHand TDC-CZ and the evaluation of curability.Results: 1st RD and 2nd RD according to TDC-CZ classification include 85.1% MTT and its curabi-lity comprises 100%. At 3rd RD cure rate drops to 64.3% and at 4th RD to 55.6%. According to FIGOclassification 1st RD comprises 48%, 2nd RD 17% and their cure rate is also 100%. The 3rd/a RDincludes 20% and curability is 100%, 3rd/bc RD includes 10% with cure rata of 67% and 4th RD/abccomprises 5% with 50% curability.According to WHO 1 of RD (< 5 score) includes 81,2% and cure rate 99,2%. 2nd RD (= 5-7 score) has9.1% and 92.9% cure rate. 3rd RD (8-12 score) comprises 4.5% and 57.1% cure rate and 4th RD (> 12score) includes 5.2% with 50% cure rate.According to NIH 1st RD (=A) comprises 64.9% with 100% curability and 2nd RD (=B1) includes20.1% with 100% curability. 3rd and 4th RD according to NIH B2 comprise 14.9% and have 60.9%curability.Curability depends on histologic type of MTT. In differentiated forms curability comprises 96.7%and in undifferentiated forms summarized 76.9%, fluctuating according to subtypes from 60% to88.9%.Conclusion: Comparing the cure rate according to classification FIGO, WHO, NIH and TDC-CZ in367 MTT treated in the TDC-CZ in the Czech Republic during the years 1955 - 2000 it becomesclear that relevant prognostic-risk classification must factually specify: 1. Staging with specificlocation of metastasis, 2. Independent risk factors verified by multifactorial analysis 3. Histolo-gic type with expression of differentiated and undifferentiated components of MTT.

Key words:
malignant trofoblastic tumours, typing, prognostic classifications, curability

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