Gestational trophoblastic disease II: classification and management of gestational trophoblastic neoplasia.

John R Lurain

Journal: American journal of obstetrics and gynecology 2011;204(1):11-8

PMID: 20739008

Full Text on Elsevier Science View on PubMed

Abstract

Gestational trophoblastic neoplasia (GTN) includes invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor. The overall cure rate in treating these tumors is currently >90%. Thorough evaluation and staging allow selection of appropriate therapy that maximizes chances for cure while minimizing toxicity. Nonmetastatic (stage I) and low-risk metastatic (stages II and III, score <7) GTN can be treated with single-agent chemotherapy resulting in a survival rate approaching 100%. High-risk GTN (stages II-IV, score ≥7) requires initial multiagent chemotherapy with or without adjuvant radiation and surgery to achieve a survival rate of 80-90%.

Address: John I. Brewer Trophoblastic Disease Center, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. [email protected]

DOI: 10.1016/j.ajog.2010.06.072

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MeSH Terms: Antineoplastic Combined Chemotherapy Protocols, Biomarkers, Tumor, Chorionic Gonadotropin, Dactinomycin, Drug Administration Schedule, Female, Gestational Trophoblastic Disease, Humans, Hysterectomy, Leucovorin, Methotrexate, Neoplasm Staging, Pregnancy, Remission Induction, Treatment Failure