798P - Survival analysis of non-metastatic gestational choriocarcinoma (NMGCC) patients treated with chemotherapy

Background

To date, there is no consensus on the FIGO recommendations for NMGCC in which chemotherapy (CTX) should be initiated after diagnosis in these patients. Therefore, we conducted the first study involving a large sample of patients with NMGCC to evaluate the effect of chemotherapy on overall survival (OS) and cancer-specific survival (CSS) in patients with NMGCC.

Methods

Data were obtained from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2019. Patients who met any of the following criteria were excluded: diagnosis not confirmed by histology; not the first tumor or other malignancies in the body; not arising from the placenta; unknown data; or metastatic status. Chi-square tests were used to compare clinicopathological features, while survival rates and prognostic factors were identified using the Kaplan-Meier estimator, log-rank tests, and Cox proportional hazard regression.

Results

The study population comprised 526 patients. Among them 128 patients with “Surgery,” 127 patients with “CTX” and 261 patients with “Surgery + CTX”. Most patients (55.3%) were aged 30 years or older, with a median age of 32 years. The largest racial group was white (63.5%; n=334). A total of 54.4% of the patients had a tumor size greater than 4 cm, with a median tumor size of 4.2 cm. Most cases were localized (71.5%, n=376). “Surgery + CTX” had the most favorable survival outcome with a 5-year OS of 96.6%, followed by “Surgery” (95.9%) and then “CTX” (93%). No significant differences were found in OS or CSS between the groups (P<0.33 and P<0.57, respectively). Older age was a poor prognostic factor for the OS and CSS. Multivariable analysis confirmed that there was no statistically significant difference between the effect of all therapeutic groups on OS and CSS, “Surgery + CTX” (HR=0.7, 95%CI:0.28-1.8 and HR=0.65, 95%CI:0.2-2, respectively).

Conclusions

The results of this study showed that CTX did not affect OS or CSS in patients with NMGCC. Multicenter prospective studies are needed to validate and build upon these findings; however, our results provide a starting point for a better understanding of these rare cancers.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.