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

Abstract

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.

Population: A total of 234 women with a diagnosis of gestational choriocarcinoma, in the absence of a prior molar pregnancy, managed at the UKs two gestational trophoblast centres in London and Sheffield.

Methods: Retrospective review of the patient's demographic and clinical data. Comparison with contemporary UK birth and pregnancy statistics.

Main outcomes: Incidence statistics for non-molar choriocarcinoma across the maternal age groups. Cure rates for patients by FIGO prognostic score group.

Results: Over the 21-year study period, there were 234 cases of non-molar gestational choriocarcinoma, giving an incidence of 1:66 775 relative to live births and 1:84 226 to viable pregnancies. For women aged under 20, the incidence relative to viable pregnancies was 1:223 494, for ages 30-34, 1:80 227, and for ages 40-45, 1:41 718. Treatment outcomes indicated an overall 94.4% cure rate. Divided by FIGO prognostic groups, the cure rates were low-risk group 100%, high-risk group 96% and ultra-high-risk group 80.5%.

Conclusions: Non-molar gestational choriocarcinoma is a very rare diagnosis with little prior detailed information on the demographics and natural history. The data in this study give age-related incidence data based on a large national population study. The results also demonstrated the widely varying natural history of this rare malignancy and the marked correlation of disease incidence with rising maternal age.

Tweetable abstract: National gestational choriocarcinoma database indicates a close association between increasing maternal age and incidence.

Keywords: Chemotherapy; choriocarcinoma; demographics; incidence.