Clinical features and demographic characteristics of gestational trophoblastic neoplasia: Single center experience and the SEER database

The aim of this study was to analyze the clinical features and demographic characteristics of gestational trophoblastic neoplasia (GTN) patients, specifically choriocarcinoma (CC), placental site trophoblastic tumor (PSTT), and epithelioid trophoblastic tumor (ETT). We utilized data from a local hospital and the Surveillance, Epidemiology, and End Results database (SEER), as well as survival outcomes of CC in the SEER database. Additionally, we used multiple risk factors to create a prognostic nomogram model for CC patients. The study included GTN patients from the SEER database between 1975 and 2016 as well as those from the First Affiliated Hospital of Xi'an Jiaotong University between January 2005 and May 2022. Related factors of patients were compared using the chi-square (chi 2) or Fisher's exact test. For assessing overall survival, we employed the Kaplan-Meier method and log-rank test. To construct the nomogram, we used Cox regression. Statistically significant differences were found between CC and PSTT/ETT patients in terms of surgery in local hospital, as well as age and year of diagnosis in the SEER database. Moreover, significant differences were observed between low and high (HR)/ultra-high risk (UHR) groups regarding FIGO stage, surgery, and chief complaint at the local hospital, and FIGO stage, surgery, and unemployment in the SEER database. The Cox regression analysis confirmed that age, race, surgery, marital status, FIGO stage, and unemployment were correlated with CC prognosis. Furthermore, the analysis showed that patients aged 40 years or older and those with FIGO stage III/IV were independent prognostic factors of CC. The study indicates that atypical symptoms or signs may be the main reasons for HR/UHR patients to seek medical treatment. Therefore, providing multidisciplinary care is recommended for CC patients experiencing psychological distress due to unfavorable marital status or unemployment.