Fertility Sparing Therapy in Patients with Intermediate Trophoblastic Tumors

  Objective  To investigate the methodologies of fertility sparing therapy in treating intermediate trophoblastic tumors (ITTs) and analyze their outcomes.

  Methods  The clinical data of 6 patients with ITTs who underwent fertility sparing therapy in our department from January 1999 to March 2010 were retrospectively analyzed.

  Results  Serum β-hCG of two patients returned normal after treated by dilation and curettage. Serum β-hCG of two patients returned normal after two courses of combined chemotherapy. Three patients were cured after open uterine tumor resection and combined chemotherapy. The gross pathology of three ITTS were polypoid, which were controlled by combined chemotherapy following dilation and curettage. Two of three patients with nodular masses type were cured by a multi-modality treatments that combined dilation and curettage with chemotherapy, followed by open uterine tumor resection (the other one did not undergo dilation and curettage). The average follow-up time was 35 months. All patients experienced complete remission (CR). Menstruation returned normal in all patients. No recurrence was noted during follow-up. No one had been pregnant.

  Conclusions  Fertility sparing therapy is safe and feasible for ITTs patients under the following conditions:younger than 35 years and having a strong wish to get pregnant in future; the tumor is localized in uterus; and multifocal disease (the diffuse infiltrative type) has been excluded.