OBJECTIVE: We reviewed cases of @entity1470 from the New England @entity1469 Center (NETDC) database from 1982-1999 in an effort to identify prognostic factors for recurrent disease. METHODS: A chart review was performed utilizing @entity1 identified from the NETDC database. Data obtained included @entity1 age at diagnosis, antecedent pregnancy, duration and extent of disease, presenting symptoms, pre- and posttreatment @entity3566 levels, diagnostic and therapeutic procedures, treatment and outcome of @entity1 . Statistical analysis was performed using Student's t test and chi(2) test when appropriate. RESULTS: Thirteen @entity1 were identified. All ultimately underwent hysterectomy although initial treatment of 1 @entity1 was uterine resection. There were 5 recurrences (43%)--3 among the 9 @entity1 who had no @entity3 on presentation (33%) and 2 of 3 @entity1 who presented with @entity3 (66%). The 5 @entity1 who recurred were among 8 who had received peri- or postoperative chemotherapy (62.5%). Treatment of recurrences included continued or alternate chemotherapy, radiotherapy, and/or excision of locally recurrent disease. Follow up time averaged 56.2 months (range 12-182 months). One of the 4 @entity1 receiving chemotherapy < or =1 week after hysterectomy recurred, whereas all 4 @entity1 who received chemotherapy 3 weeks or more after hysterectomy recurred. Uterine @entity5 volume was significantly greater, 154.1 cm(3), in @entity1 with initial @entity3 versus 42.3 cm(3) in @entity1 without initial @entity3 (P = 0.04). Mitotic index (P = 0.04) was significantly increased in @entity1 who developed recurrent disease. CONCLUSION: High mitotic index appears to be an adverse prognostic indicator for recurrence. Hysterectomy remains the mainstay of treatment. Chemotherapy is indicated for @entity1 with @entity3 and may be indicated when the mitotic index is >5 mitoses/10 HPF. Radiation treatment may play a role in recurrent disease but must be evaluated on a case-by-case basis.

@entity1470 : a 17-year experience at the New England XXXX Center.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity1469 :: ('MESH:D031901', 'Disease') :: ['Trophoblastic Disease'] @entity1470 :: ('MESH:D018245', 'Disease') :: ['placental site trophoblastic tumors'] @entity3566 :: ('3342', 'Gene') :: ['hCG'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases']
@entity1469 :: (MESH:D031901,Disease) :: ['Trophoblastic Disease']
