{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:50:39Z","timestamp":1791352239072,"version":"4.3.1"},"reference-count":31,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asia-Pac J Clncl Oncology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Rare cancers such as gestational trophoblastic neoplasia (GTN) should be managed in specialized centers, allowing for multidisciplinary team input, expert pathology review, consensus\u2010based treatment and surveillance pathways, and improved patient survival and patient\u2010reported outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study assessed the impact of centralized care implementation at a tertiary academic women's hospital on patients diagnosed and treated with GTN between 2021 and 2024 in Western Australia. Clinical outcomes compared 2 years pre\u2010centralization (2021\u20132022) and 2 years post\u2010centralization (2023\u20132024). The post\u2010centralized patient experience was assessed via surveys.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 36 patients with GTN were included: 20 pre\u2010centralization and 16 post\u2010centralization. Over the 4\u2010year study period, 32 patients were categorized as low\u2010risk, two were high\u2010risk, and two had high\u2010risk histology that precluded prognostic risk assignment. Centralization of care led to an improvement in identifying those who met the diagnostic criteria for GTN (65%\u00a0vs. 100%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.011) and subsequent appropriate chemotherapeutic intervention, as well as better accuracy in the assignment of International Federation of Gynecology and Obstetrics (FIGO) stage (41%\u00a0vs. 89%) and World Health Organization (WHO) prognostic score (46%\u00a0vs. 82%). Methotrexate was favored as first\u2010line chemotherapy for low\u2010risk disease in both groups. There have been no relapses or deaths in either group to date. Centralization of care led to improved contraceptive counseling documentation (65%\u00a0vs. 87.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.026) yet similar pregnancy rates. The\u00a0patient\u00a0experience with centralized care was positive.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although study numbers are small, this study supports the establishment of centralized centers for rare trophoblastic diseases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajco.70199","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:07:55Z","timestamp":1791349675000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of Centralized Trophoblastic Care on Patients With Gestational Trophoblastic Neoplasia in a Statewide Service"],"prefix":"10.1111","author":[{"given":"Chloe","family":"Ayres","sequence":"first","affiliation":[{"name":"King Edward Memorial Hospital Western Australian Gynaecologic Cancer Service  Subiaco Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyn","family":"Werner","sequence":"additional","affiliation":[{"name":"King Edward Memorial Hospital Western Australian Gynaecologic Cancer Service  Subiaco Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivienne","family":"Mallen","sequence":"additional","affiliation":[{"name":"King Edward Memorial Hospital Western Australian Gynaecologic Cancer Service  Subiaco Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Kember","sequence":"additional","affiliation":[{"name":"King Edward Memorial Hospital Western Australian Gynaecologic Cancer Service  Subiaco Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danelle","family":"Ward","sequence":"additional","affiliation":[{"name":"King Edward Memorial Hospital Western Australian Gynaecologic Cancer Service  Subiaco Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma R.","family":"Allanson","sequence":"additional","affiliation":[{"name":"King Edward Memorial Hospital Western Australian Gynaecologic Cancer Service  Subiaco Western Australia Australia"},{"name":"Division of Obstetrics and Gynaecology University of Western Australia Medical School  Crawley Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"issue":"18","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"2119","DOI":"10.1200\/JCO-24-02326","article-title":"Practical Guidelines for the Treatment of Gestational Trophoblastic Disease: Collaboration of the European Organisation for the Treatment of Trophoblastic Disease (EOTTD)\u2010European Society of Gynaecologic Oncology (ESGO)\u2010Gynecologic Cancer InterGroup (GCIG)\u2010International Society for the Study of Trophoblastic Diseases (ISSTD)","volume":"43","author":"Lok C.","year":"2025","journal-title":"Journal of Clinical Oncology"},{"issue":"5","key":"e_1_2_9_3_1","first-page":"188","article-title":"Subsequent Pregnancy Outcomes After Complete and Partial Molar Pregnancy, Recurrent Molar Pregnancy, and Gestational Trophoblastic Neoplasia: An Update From the New England Trophoblastic Disease Center","volume":"59","author":"Vargas R.","year":"2014","journal-title":"Journal of Reproductive Medicine"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13023\u2010024\u201003322\u20107"},{"issue":"3","key":"e_1_2_9_5_1","first-page":"151","article-title":"Reduction of Postmolar Gestational Trophoblastic Neoplasia by Early Diagnosis and Treatment","volume":"54","author":"Ben\u2010Arie A.","year":"2009","journal-title":"Journal of Reproductive Medicine"},{"issue":"7","key":"e_1_2_9_6_1","first-page":"305","article-title":"Influence of Hydatidiform Mole Follow\u2010Up Setting on Postmolar Gestational Trophoblastic Neoplasia Outcomes: A Cohort Study","volume":"57","author":"Dantas P. 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