Twenty-five years' clinical experience with XXXX .

@entity1 @entity3556 @entity1469 @entity1470 @entity204
OBJECTIVE: To describe 34 cases of @entity1470 ( @entity1470 ) treated at Charing Cross Hospital over 25 years. STUDY DESIGN: Between 1975 and 2001, 1,685 @entity1 with @entity1469 ( @entity1469 ) were treated; 34 of them had @entity1470 (2%). The computer database clinical notes and the pathology reports were accessed to obtain data on this @entity1 group. The data were subsequently analyzed using Excel computer software. RESULTS: The mean age of the group was 33 years (95% CI 25-41). The antecedent pregnancy was a full-term, normal one in 18 cases (53%), a molar pregnancy in 7 (21%) and a missed abortion in 5 (15%). The mean interval from the last pregnancy to diagnosis was 3.4 years (95% CI 1.9-4.9). The range of serum hCG concentrations at diagnosis was 0-58,000, 79% with levels < 1,000 and 58% < 500. hCG was raised in all with active disease. The most frequent presenting complaint was @entity3556 , in 27 cases (79%). At diagnosis, the disease was localized to the uterus in 15 (44%); there was pelvic involvement in 8 (24%) and lung secondaries in 10 (29%). All seven @entity204 were disease related (21%); all had lung secondaries and presented more than four years since the last pregnancy. Excluding the seven @entity204 , the primary treatment was surgery alone in 10 cases (37%) (8 hysterectomies and 2 dilatation and curettages); 4 had surgery followed by adjuvant chemotherapy; 5 had neoadjuvant chemotherapy followed by surgery; 1 had chemotherapy alone, and the disease recurred and was successfully rechallenged; and 5 had surgery between chemotherapy cycles. The most common regimens consisted of EMA/CO and EP/EMA. CONCLUSION: Risk factors for @entity204 include lung metastatic involvement (50%) and an antecedent pregnancy interval of four years or more (100%). In contrast, those with no extrapelvic disease or a pregnancy interval of less than four years had 100% survival. In two-thirds of @entity1 with disease limited to the uterus, surgery alone was curative. The WHO scoring system for @entity1469 did not correlate with this outcome. @entity1 with @entity1470 should be managed separately from those with other types of @entity1469 , as the disease behavior is different.
