Uterine corpus malignancies with pregnancy-like features lead to poor survival outcomes

A new review was published in Volume 12 of Oncoscience on September 4, 2025, titled "Prognostic significance of trophoblastic differentiation and β-hCG secretion in somatic malignancies of uterine corpus: A systematic review with survival analysis."

This systematic review, led by first author Mishu Mangla and corresponding author Seetu Palo from the All India Institute of Medical Sciences, Bibinagar, examined rare uterine tumors that produce the hormone beta-human chorionic gonadotropin (β-hCG) or show features of trophoblastic differentiation, a condition in which cancer cells start to resemble the specialized cells normally found in the placenta during pregnancy. The authors found that these tumors are often aggressive, spread early, and lead to poor survival outcomes. These findings may help clinicians better identify high-risk uterine cancers that require closer monitoring and more personalized treatment approaches.

The review analyzed 40 published cases of uterine corpus malignancies with either β-hCG secretion or trophoblastic features. Although rare, these tumors were found to behave more aggressively than typical uterine cancers. They often presented with early metastasis, particularly to the lungs, and demonstrated resistance to both chemotherapy and radiotherapy. Most patients were post-menopausal, and common symptoms included abnormal or post-menopausal bleeding. Risk factors such as obesity, diabetes, and hypertension were also frequently observed.

Tumors that produced β-hCG or displayed trophoblastic differentiation were generally high-grade and poorly differentiated. Nearly half of the patients included in the review died within 10 months of diagnosis, and only about 30% remained disease-free after treatment. The authors noted that early detection and disease staging were the only factors consistently associated with improved survival. However, even early-stage tumors often showed signs of extensive spread, emphasizing the need for more effective diagnostic tools.

While treatment strategies varied between cases, a few patients showed improved outcomes after receiving a chemotherapy combination called EMACO, which is typically used for gestational trophoblastic disease. This suggests it might be a potential treatment option, although more comparative research is needed to confirm its broader effectiveness. Currently, there are no standardized treatment protocols for these rare tumor types, leaving clinicians to make individualized decisions based on limited data.

"All three cases where a combination of Etoposide, Methotrexate, Actinomycin-D, Cyclophosphamide and Vincristine (EMACO) was used as neoadjuvant chemotherapy, survived, and one case where Bleomycin, etoposide and platinum (BEP) was used as neoadjuvant chemotherapy, died at 6 months after disease diagnosis due to cerebral metastasis leading to haemorrhage."

By compiling global evidence on this rare cancer subtype, the review provides key knowledge for oncologists and pathologists, reinforcing the role of β-hCG as a potential marker of poor prognosis and the need for more tailored treatment strategies.