Study design and sample
We conducted a retrospective analysis including a total of 313 patients
with GTN who were diagnosed and treated at the Hospital of Obstetrics
and Gynecology, Fudan University in Shanghai, China from January 2014 to
December 2017. Placental site trophoblastic tumor (PSTT) and
extrauterine epithelioid trophoblastic tumors (ETT) are insensitive to
chemotherapy and usually require adjuvant surgery14;
these have distinct biological behaviors with typical
GTN15. Twelve patients with pathologically confirmed
PSTT and three with ETT were excluded, leaving 298 GTN patients for
analyses, including 233 (78.2%, 233/298) low-risk GTN (FIGO score ≤6)
and 47 (15.8%, 47/298) high-risk GTN (FIGO score 7–11), and 18 (6.0%,
18/298) ultra-high-risk GTN (FIGO >12, as well as patients
with liver, brain, or extensive metastases) (Figure 1). The clinical
characteristics, treatment details, outcomes, and prognoses of these 298
patients with GTN were retrieved from the medical records in our
hospital. Ethical approval was
obtained from the Ethics Committee of Hospital of Obstetrics and
Gynecology, Fudan University, Shanghai, China.