Demographics, Natural History and Treatment Outcomes of Non-Molar Gestational Choriocarcinoma; A UK population study.

Objective To investigate the demographics, natural history and treatment outcomes of non-molar gestational choriocarcinoma. Design A retrospective national population-based study. Setting UK 1995-2015. Population A total of 234 women with a diagnosis of gestational choriocarcinoma, in the absence of a prior molar pregnancy, managed at the UKs two gestational trophoblast centres in London and Sheffield. Methods Retrospective review of the patient's demographic and clinical data. Comparison with contemporary UK birth and pregnancy statistics. Main outcomes Incidence statistics for non-molar choriocarcinoma across the maternal age groups. Cure rates for patients by FIGO prognostic score group. Results Over the 21-year study period, there were 234 cases of non-molar gestational choriocarcinoma, giving an incidence of 1:66 775 relative to live births and 1:84 226 to viable pregnancies. For women aged under 20, the incidence relative to viable pregnancies was 1:223 494, for ages 30-34, 1:80 227, and for ages 40-45, 1:41 718. Treatment outcomes indicated an overall 94.4% cure rate. Divided by FIGO prognostic groups, the cure rates were low-risk group 100%, high-risk group 96% and ultra-high-risk group 80.5%. Conclusions Non-molar gestational choriocarcinoma is a very rare diagnosis with little prior detailed information on the demographics and natural history. The data in this study give age-related incidence data based on a large national population study. The results also demonstrated the widely varying natural history of this rare malignancy and the marked correlation of disease incidence with rising maternal age. Tweetable abstract National gestational choriocarcinoma database indicates a close association between increasing maternal age and incidence.