Current oncology (Toronto, Ont.) · 2026
Gestational Trophoblastic Neoplasia Following Hydatidiform Mole and Non-Molar Pregnancy: Clinical and Prognostic Features from a 40-Year Cohort Study at a Reference Center in Southern Brazil.
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Uberti Elza Maria Hartmann, Medeiros Lidia Rosi de Freitas, Cardoso Rodrigo Bernardes, Silveira Eduardo, Patias Cassiano Burman, Santos Filho Carlos Eduardo Dos, Reis Rosilene Jara, Copetti Josenel Maria Barcelos, Furtado Jose Pio
Аннотация
BACKGROUND: Gestational trophoblastic neoplasia (GTN) is rare but highly curable. This study compared clinical characteristics and outcomes between molar and non-molar disease.
METHODS: This retrospective cohort included 550 patients at a Brazilian reference center (1985-2025). Survival was assessed using Kaplan-Meier methods. Multivariable analyses included Poisson and Cox regression models.
RESULTS: Molar GTN comprised 86% of cases. Non-molar GTN (14%) presented with more advanced FIGO stages, higher WHO risk scores, and more metastases (p < 0.001). Overall five-year disease-specific survival (DSS) was 97.4% (95% CI 95.9-98.9) and progression-free survival (PFS) was 92.4% (95% CI 90.1-94.7). Non-molar disease had lower DSS (84.4% vs. 99.8%; p < 0.001) and PFS (85.3% vs. 93.5%; p = 0.049) in unadjusted analyses. However, after multivariable adjustment, GTN type was not independently associated with DSS (HR 9.41; 95% CI 0.70-127; p = 0.092) or PFS (HR 1.61; 95% CI 0.57-4.60; p = 0.372). Non-molar patients had a lower likelihood of subsequent pregnancy (RR 0.60; 95% CI 0.36-1.00; p = 0.049).
CONCLUSIONS: Although non-molar GTN presents with more aggressive clinical features, survival outcomes appear to be primarily driven by baseline disease severity rather than GTN subtype itself.
METHODS: This retrospective cohort included 550 patients at a Brazilian reference center (1985-2025). Survival was assessed using Kaplan-Meier methods. Multivariable analyses included Poisson and Cox regression models.
RESULTS: Molar GTN comprised 86% of cases. Non-molar GTN (14%) presented with more advanced FIGO stages, higher WHO risk scores, and more metastases (p < 0.001). Overall five-year disease-specific survival (DSS) was 97.4% (95% CI 95.9-98.9) and progression-free survival (PFS) was 92.4% (95% CI 90.1-94.7). Non-molar disease had lower DSS (84.4% vs. 99.8%; p < 0.001) and PFS (85.3% vs. 93.5%; p = 0.049) in unadjusted analyses. However, after multivariable adjustment, GTN type was not independently associated with DSS (HR 9.41; 95% CI 0.70-127; p = 0.092) or PFS (HR 1.61; 95% CI 0.57-4.60; p = 0.372). Non-molar patients had a lower likelihood of subsequent pregnancy (RR 0.60; 95% CI 0.36-1.00; p = 0.049).
CONCLUSIONS: Although non-molar GTN presents with more aggressive clinical features, survival outcomes appear to be primarily driven by baseline disease severity rather than GTN subtype itself.