Long-term outcome and fertility results of intraplacental choriocarcinoma: a retrospective study of 14 patients and literature review.

Objective: Intraplacental choriocarcinoma (IC) is a rare subtype of gestational choriocarcinoma, and the long-term follow-up and reproductive outcomes of IC patients remain unclear. Here, we report a series of 14 cases aimed at assessing fertility and recurrence results at long-term follow-up. Methods: This was a retrospective cohort study of 14 patients with pathologically confirmed IC treated in Peking Union Medical College Hospital (PUMCH) from 2002 to 2022. The clinical characteristics, perinatal outcomes, treatment, recurrence rate and fertility results were analyzed. Results: In total, 2,150 patients were diagnosed with gestational choriocarcinoma at PUMCH during this period, and fourteen (0.7%) had IC and were included in this study. Half of them had metastatic IC and were treated by chemotherapy with or without surgery. Only 1 patient had chemotherapy-resistant disease, but she achieved complete remission after immunotherapy. The median follow-up time was 45.5 months (range, 4-192), and no recurrence occurred. One metastatic IC patient who achieved remission after chemotherapy had a full-term delivery. Among the 5 patients with fertility demands, 3 abandoned their pursuit of pregnancy because of "fear and worry about choriocarcinoma recurrence." Conclusion: IC is sensitive to chemotherapy and has good long-term remission and a low recurrence rate. Patients with metastatic IC can still have good pregnancy results after treatment. Doctors should pay more attention to the psychology of these patients. [ABSTRACT FROM AUTHOR]