Clinical routine care for choriocarcinoma: a descriptive analysis of data from the Baden-Wuerttemberg Cancer Registry (BWCR)

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PURPOSE: Choriocarcinoma is a rare tumour. In Germany, due to its low incidence and lack of centralisation in care, only limited data are available on real-world clinical practice. This study aims to analyse tumour characteristics, treatment, and outcomes of patients with gestational choriocarcinoma using data from the Baden-Wuerttemberg Cancer Registry (BWCR), Germany. METHODS: We included patients aged 18-50 years diagnosed with choriocarcinoma between 2015 and 2023, reported to the BWCR. The cases were identified using ICD-O-3 codes 9100/3, 9101/3 and ICD-10-GM code C58.9. Diagnostic and treatment information was derived from standardised registry entries and pathology reports. First-line treatment was defined as therapy initiated within 120 days of diagnosis. Data were analysed using descriptive statistics. RESULTS: 38 patients (mean age 33.4 years) were included; 39% presented with metastatic disease, predominantly isolated lung metastases (67%). Systemic therapy was reported in 28 cases: MTX (n = 10), EMA-CO (n = 12), and - due to timecourse or substance - other regimens (n = 6). The reported treatment duration ranged from 20 - 120 days (MTX) and 50 -154 days (EMA-CO). One MTX-treated patient (10%) required escalation to EMA-CO. Among EMA-CO cases, therapy was discontinued in three patients and one second-line treatment reported. The reported adverse events were in line with published data. CONCLUSION: This population-based analysis provides real-world insights into choriocarcinoma care in Baden-Wuerttemberg. While outcomes align with current guidelines, observed resistance to MTX and EMA-CO highlights the need for individualised treatment and closer monitoring. These findings underline the value of registry data in guiding therapy optimization-even in rare diseases like choriocarcinoma.