分析宫底部滋养层肿瘤(PSTT)患者的保育生育治疗方法、可行性、效率和繁殖结果。收集了北京协和医院1998年4月至2020年4月诊断为PSTT的患者的临床数据进行回顾性研究。分析了接受保育生育治疗的患者的临床特征、治疗和结果，并将其与接受子宫切除的患者进行比较。本研究共纳入126名患者，其中29名接受了保育生育治疗。保育生育组的年龄显著更年轻，先前分娩比例较低，但两组之间的病期、血清β-hCG水平和先前妊娠间期没有显著差异。采用个体化的保守手术方法，无一例需要营救子宫切除。具有临床或病理高危因素的患者接受了辅助化疗，但保育生育治疗并未明显延长化疗持续时间。所有保育生育组的患者在随访36至176个月后均完全缓解且无复发，并在治疗后一年以上成功生育16个健康婴儿。对于非广泛扩散的子宫局部病变且急需保留生育能力的年轻患者，可考虑保育生育治疗。通过个体化的保守手术及选择性的辅助化疗，保育生育治疗不会影响疾病复发及总体生存率，患者的妊娠及分娩效果也更为有利。版权所有©2023 Elsevier Inc.。

To analyze the methods, feasibility, efficiency, and fertility outcomes of fertility-sparing treatment for patients with placental site trophoblastic tumor (PSTT).Clinical data of patients diagnosed with PSTT between April 1998 and April 2020 from Peking Union Medical College Hospital (PUMCH) were retrospectively collected. The clinical features, treatment, and outcomes of patients received fertility-sparing treatment were analyzed and compared with patients suffered hysterectomy.In total, 126 patients were included in the study and 29 of them received fertility-sparing treatment. Besides significantly younger age and lower proportion of antecedent term delivery were seen in fertility-sparing group than hysterectomy group, no significant differences were observed in stage, serum β-hCG level, or interval from antecedent pregnancy between the two groups. Conservative surgery was selected individualized and none of them suffered salvage hysterectomy. Patients with clinical or pathological high-risk factors received adjuvant chemotherapy, yet the fertility-sparing treatment did not significantly lengthen chemotherapy duration. All patients in fertility-sparing group achieved complete remission without relapse after 36 to 176 months of follow-up and had sixteen healthy term delivery more than one year after the treatment.Fertility-sparing treatment for PSTT can be considered for young patients with localized uterine lesions who strongly desire to preserve their fertility potential. With individualized conservative surgery and selected adjuvant chemotherapy, fertility-sparing treatment will not influence the risk of relapse or overall survival and patients will achieve favorable pregnancy and live birth outcomes.Copyright © 2023. Published by Elsevier Inc.