Clinical and demographic profiles and predictors of survival in epithelioid trophoblastic tumors: A population-based analysis.

Abstract

5615 Background: Epithelioid trophoblastic tumor (ETT) is a rare form of gestational trophoblastic neoplasia. Existing studies on ETT have been limited by small sample sizes and a lack of robust socioeconomic and demographic analyses. This study aims to characterize the clinical and demographic profiles of ETT patients and evaluate survival outcomes. Methods: ETT cases diagnosed between 2000 and 2021 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Survival outcomes were analyzed with Kaplan-Meier survival analysis, and the statistical significance of key variables was assessed using the log-rank test. Hazard ratios (HR) were calculated using Cox proportional hazards regression models. This data is compared to what is currently known based on the published literature. Results: A total of 100 patients with ETT were identified. The majority of cases (76%) were in patients aged 30 to 49 years. The cohort was predominantly white race (60%), with 72% identifying as Non-Spanish-Hispanic-Latino. Of patients with staging information (57%), 30% had localized disease. Socioeconomic analysis revealed that 60% of patients had a median household income below $80,000 annually, and 71% resided in metropolitan areas with populations exceeding one million. Black patients had risk of mortality compared to white patients [HR = 3.233; 95% CI: (1.021, 10.240), p = 0.046]. Patients with distant metastases or nodal involvement had significantly worse survival outcomes compared to those with localized disease [HR = 11.813; 95% CI: (1.379, 101.190); p = 0.024]. Among treatment modalities, 65% of patients underwent surgery, 33% received chemotherapy, and 3% received radiation therapy. Patients who received chemotherapy demonstrated a higher risk of mortality compared to those who did not [HR = 5.937; 95% CI: (1.788, 19.710); p = 0.004]. Conclusions: ETT patients exhibit significant survival differences based on race, distant disease at diagnosis, and chemotherapy use. These findings highlight the importance of addressing racial disparities, early diagnosis, and optimizing treatment strategies to improve outcomes for this rare malignancy. Further research is warranted to refine our understanding and guide clinical management.