Research

Sheffield is one of the two UK Centres treating trophoblastic tumours. The Sheffield Trophoblastic Screening and Treatment Centre covers a population of over 22 million from the North of England and North Wales.

JustGiving

You can raise money for Trophoblastic Disease Research in Sheffield using the University of Sheffield's JustGiving registration.

To make sure the money reaches us be sure to use a page title that mentions Gestational Trophoblastic Disease, Molar Pregnancy or Jean's Research Trust Fund.

Around 600 women each year are registered in Sheffield following the diagnosis of a molar pregnancy. Therefore, there is a wealth of clinical, biochemical and histopathological date available for research.

As well as the Sheffield GTN team developing research projects we also combine with the other two centres in the UK - Charing Cross Hospital and Ninewells Hospital to develop joint projects.

Every two years the Sheffield Team attends the International Society for the Study of Trophoblastic Disease (ISSTD) conference where research from across the globe is discussed

A recent initiative of which Sheffield is part, is the European Organisation for Treatment of Trophoblastic Disease (EOTTD) formed to develop optimum treatment for GTN patients

In order to extend and focus our research we have defined three main themes - aimed broadly at:

assessing best practice in clinical management.
helping understand the aetiology.
evaluating long-term physical and psychological morbidity.

Recently completed projects:

Predicting gestational trophoblastic neoplasia (GTN): is urine hCG the answer?
Hyperthyroidism and human chorionic gonadotrophin production in gestational trophoblastic disease.
Screening for central nervous system disease in metastatic gestational trophoblastic neoplasia.
A conservative approach in persistent low-level elevation of serum beta-human chorionic gonadotropin following chemotherapy for gestational trophoblastic neoplasia.

Key publications

Key peer reviewed publications in trophoblastic disease involving the Sheffield TDC team.

Winter M.C., Tidy J., Singh K., Sarwar N., Aguiar X., Seckl M.J. Efficacy analysis of single-agent carboplatin AUC4 2-weekly as second-line therapy for methotrexate-resistant (MTX-R) low risk gestational trophoblastic neoplasia (GTN)

Gynecologic Oncology 2023, in press

Singh K, Rollins S., Ireson J. Gestational Trophoblastic Disease: Best Practice Nursing Guidelines. Gynecol Obstet Invest 2023, doi: 10.1159/000530570

Hapuarachi, B., Tidy, J. A., Romanowski, C., Singh, K., Gillett, S., Ireson, J., & Winter, M. C. Leptomeningeal disease as a presenting feature of gestational trophoblastic neoplasia: A review and recommendations for management. Gynecologic Oncology 2023, 172, 47-53. doi: 10.1016/j.ygyno.2023.03.007

Parker, V. L., Cushen, B. F., Hills, A., Kandiah, K., Palmer, J. E., Singh, K., Hancock B.W., Tidy J.A., & Winter, M. C. Flat-dose versus weight or body surface area-based methotrexate dosing in low-risk gestational trophoblastic neoplasia. Gynecologic Oncology 2023, 169, 34-40. doi: 10.1016/j.ygyno.2022.11.025

Parker, V; Winter, M.C; Tidy, J; Hancock, B; Palmer, J; Sarwar, N; Kaur, B; McDonald, K; Aguiar, X; Singh, K; Unsworth, N; Jabbar, I; Pacey, A; Harrison, R; Seckl, M. Can we improve the FIGO scoring system in Gestational Trophoblastic Neoplasia? International Journal of Cancer 2022 doi: 10.1002/ijc.34352

Winter MC. Treatment of low-risk Gestational Trophoblastic Neoplasia. Best Practice & Research Clinical Obstetrics and Gynaecology 2021. doi: 10.1016/j.bpobgyn.2021.01.006

Singh K, Gillett S, Ireson J, Hills A, Tidy JA, Coleman RE, Hancock BW, Winter MC. M-EA (methotrexate, etoposide, dactinomycin) and EMA-CO (methotrexate, etoposide, dactinomycin / cyclophosphamide, vincristine) regimens as first-line treatment of high-risk gestational trophoblastic neoplasia. International Journal of Cancer 148(9):2335-2344 May 2021. doi: 10.1002/ijc.33403

Parker VL, Winter MC, Whitby E, Parker WAE, Palmer JE, Tidy JA, Pacey AA, Hancock BW, Harrison RF. Computed tomography chest imaging offers no advantage over chest X-ray in the initial assessment of gestational trophoblastic neoplasia British Journal of Cancer 16 Dec 2020. doi: 10.1038/s41416-020-01206-8

Schink JC, Filiaci V, Huang HQ, Tidy J, Winter M, Carter J, Anderson N, Moxley K, Yabuno A, Taylor SE, et al. An international randomized phase III trial of pulse actinomycin-D versus multi-day methotrexate for the treatment of low-risk gestational trophoblastic neoplasia; NRG/GOG 275 Gynecologic Oncology 158(2):354-360 Aug 2020. doi: 10.1016/j.ygyno.2020.05.013

Lok C, van Trommel N, Massuger L, Golfier F, Seckl M, Abreu MH, Attia J, Balanchandran K, Bergamini A, Bolze PA, et al. Practical clinical guidelines of the EOTTD for treatment and referral of gestational trophoblastic disease. European Journal of Cancer 130:228-240 May 2020. doi: 10.1016/j.ejca.2020.02.011

Savage P, Winter MC, Parker V, Harding V, Sita-Lumsden A, Fisher RA, Harvey R, Unsworth N, Sarwar N, Short D, Aguiar X, Tidy J, Hancock B, Coleman R, Seckl M. Demographics, Natural History and Treatment Outcomes of Non-Molar Gestational Choriocarcinoma; A UK population study. BJOG: An International Journal of Obstetrics and Gynaecology 2020. doi: 10.1111/1471-0528.16202

Balachandran K, Salawu A, Ghorani E, Kaur B, Sebire NJ, Short D, Harvey R, Hancock B, Tidy J, Singh K, Sarwar N, Winter MC, Seckl M. When to stop human chorionic gonadotrophin (hCG) surveillance after treatment with chemotherapy for gestational trophoblastic neoplasia (GTN): A national analysis on over 4,000 patients. Gynecologic Oncology 2019. doi: 10.1016/j.ygyno.2019.07.024

Froeling FEM, Ramaswami R, Papanastasopoulos P, Kaur B, Sebire NJ, Short D, Fisher RA, Sarwar N, Wells M, Singh K, Ellis LE, Horsman JM, Winter MC, Tidy J, Hancock BW, Seckl MJ. Intensified therapies improve survival and identification of novel prognostic factors for placental site and epithelioid trophoblastic tumours. British Journal of Cancer 2019, 120 (suppl. 6):1 doi: 10.1038/s41416-019-0402-0

Frijstein M, Lok CAR, Short D, Singh K, Fisher RA, Hancock BW, Tidy JA, Sarwar N, Kanfer E, Winter MC, Savage P, Seckl MJ. The results of treatment with high-dose chemotherapy and peripheral blood stem cell support for Gestational Trophoblastic Neoplasia. European Journal of Cancer 2019; 109, 162-171. doi: 10.1016/j.ejca.2018.12.033

Earp KE, Hancock BW, Short D, Harvey RA, Fisher RA, Drew D, Sarwar N, Tidy JA, Winter MC, Chein P, Seckl MJ. Do we need post-pregnancy screening with human chorionic gonadotrophin after previous hydatiform mole to identify patients with recurrent gestational trophoblastic disease? European Journal of Obstetrics & Gynecology and Reproductive Biology 2019. doi: 10.1016/j.ejogrb.2018.12.029

Frijstein M, Lok C, van Trommel N, ten Kate Booij M, Massuger L, van Werkhoven E, Kaur B, Tidy J, Sarwar N, Golfier F, Winter MC, Hancock BW, Seckl MJ. Management and prognostic factors of epithelioid trophoblastic tumors: results from the international society for the study of trophoblastic diseases database. Gynecologic Oncology 2018; doi: 10.1016/j.ygyno.2018.11.015

Hills A, Singh K, Ireson J, Gillett S, Winter MC, Hancock BW, Tidy J. Shortened follow-up after partial molar pregnancy - a prospective evaluation based on selective histopathology review. Journal of Reproductive Medicine 2018, 63(3):213-215. Link to review.

Singh K, Warnock C, Ireson J, Strickland S, Short D, Seckl MJ, Hancock BW. Experiences of women with gestational trophoblastic neoplasia treated with high-dose chemotherapy and stem cell transplantation: a qualitative study. ONF 2017, 44(3), pp. 375–383. doi: 10.1188/17.ONF.375-383

Ireson J, Jones G, Winter MC, Radley SC, Hancock BW, Tidy JA. Systematic review of health-related quality of life and patient-reported outcome measures in gestational trophoblastic disease: a parallel synthesis approach. Lancet Oncology, 2018, e56–64. doi: 10.1016/S1470-2045(17)30686-1

Parker VL, Pacey AA, Palmer JE, Tidy JA, Winter MC, Hancock BW
Classification systems in Gestational trophoblastic neoplasia - Sentiment or evidenced based? Cancer Treatment Reviews, 2017 May, 56, pp. 47–57. doi: 10.1016/j.ctrv.2017.04.004

Gillett S, Singh K, Ireson J, Hills A, Winter M, Tidy J, Logan R, Hancock B
Evolution of a teenage and young adult service, in Sheffield, UK, for patients with gestational trophoblastic neoplasia. Journal of Reproductive Medicine, 2016, May-June, 61(5–6), pp. 235–7. Link to review.

Taylor F, Short D, Harvey R, Winter MC, Tidy J, Hancock BW, Savage PM, Sarwar N, Seckl MJ, Coleman RE. Late spontaneous resolution of persistent molar pregnancy. BJOG, 2016 June, 123(7), pp. 1175–81. doi: 10.1111/1471-0528.13867

Winter MC, Tidy JA, Hills A, Ireson J, Gillett S, Singh K, Hancock BW, Coleman RE. Risk adapted single-agent dactinomycin or carboplatin for second-line treatment of methotrexate resistant low-risk gestational trophoblastic neoplasia. Gynecologic Oncology, 2016 December, 143(3), pp. 565–570. doi: 10.1016/j.ygyno.2016.10.001

Lawrie TA, Alazzam M, Tidy J, Hancock BW, Osborne R. First-line chemotherapy in low-risk gestational trophoblastic neoplasia. Cochrane database of systematic reviews, 2016 June 9, (6). doi: 10.1002/14651858.CD007102.pub4

Macdonald MC, Hancock BW, Winter MC, Coleman RE, Tidy JA. A review of the management and outcomes of patients treated for low-risk gestational trophoblastic neoplasia in Sheffield, UK between 1997 and 2006. Journal of Reproductive Medicine, 2016, 61(7-8), pp. 341–346. Link to review.

Alazzam M, Tidy J, Osborne R, Coleman R, Hancock BW, Lawrie TA. Chemotherapy for resistant or recurrent gestational trophoblastic neoplasia. Cochrane database of systematic reviews, 2016 Jan 13, (1):CD008891. doi:10.1002/14651858.CD008891.pub2

Price JM, Lo C, Abdi S, Winter MC, Coleman RE, Tidy J, Hancock BW. The Role of Computed Tomography Scanning of the Thorax in the Initial Assessment of Gestational Trophoblastic Neoplasia. International Journal of Gynecological Cancer, 2015 November, 25(9), pp. 1731–6. doi: 10.1097/IGC.0000000000000534

Agarwal R, Alifrangis C, Everard J, Savage PM, Short D, Tidy J, Fisher RA, Sebire NJ, Harvey R, Hancock BW, Coleman RE, Seckl MJ. Management and survival of patients with FIGO high-risk gestational trophoblastic neoplasia: the U.K. experience, 1995-2010. The Journal of Reproductive Medicine, 2014 January-February, 59(1-2), pp. 7–12. Link to review.