Primary pulmonary choriocarcinoma - literature review; gestational event determines better survival

Aim: To establish whether there are different clinical entities of primary pulmonary choriocarcinoma (PPC) that deserve different diagnostic approach and the most optimal treatment of PPC. Patients and methods: A systematic review with PubMed search was conducted to identify studies that reported cases of PPC. Results: Women with history of gestational event showed better survival outcome than women without the history of gestational event (p=0,040). Patients treated with combination of surgery and chemotherapy survived longer than the patients without combination of surgery and chemotherapty (p=0,010). Futhermore, multivariate analysis of prognostic factors showed that the treatment combining surgery with chemotherapy had independent prognostic significance (p=0,031). Conclusion: PPC is an extreme rarity with variable clinical characteristics and outcome. Women with history of gestational event showed better survival, therefore genetic examination of PPC can help us to predict patient’s prognosis. Surgery followed by adjuvant chemotherapy appears to represent the best treatment for PPC.