Choriocarcinoma after a nonterm pregnancy

To evaluate the characteristics and outcomes of patients with choriocarcinoma following a nonterm pregnancy and compare them to the results from the same unit of patients with choriocarcinoma following a term delivery.

A retrospective case review of all patients with choriocarcinoma after a nonterm pregnancy referred to the Trophoblastic Screening and Treatment Centre, Sheffield, between 1976 and 2008.

Sixty-four patients were referred after a nonterm pregnancy. Time to diagnosis was longer in the nonterm pregnancy patients compared to patients referred following a term pregnancy. Mean human chorionic gonadotrophin (hCG) level, however, was lower in the nonterm pregnancy group: 91,329 IU/L vs. 192,121 IU/L for the term pregnancy group. The number of patients with metastases at presentation was similar in both groups (57% following term pregnancy, 51% following nonterm pregnancy), although more of the nonterm pregnancy patients received methotrexate therapy only: 36% vs. 23%. Survival in both groups was > 90%.

The presence of metastases, excluding pulmonary, had an adverse effect on outcome in both groups and, in accord with published data, that site and number of metastases have more impact on outcome than type of antecedent pregnancy.