title: Management of high-risk gestational trophoblastic disease.
abstract: Traditionally in the United States, women have been categorized as having high-risk gestational trophoblastic disease on the basis of traditional risk criteria and have been treated in a similar fashion at most centers. Utilizing more objective and specific scoring systems allows an analysis of the most recently reported results of the treatment of high-risk patients. Identification of the "ultra-high-risk" patient allows a comparison of various therapeutic regimens at different centers. Such an analysis demonstrated the inadequacy of the traditional methotrexate/actinomycin-D/chlorambucil and modified Bagshawe regimens for these patients. Superior results have been achieved utilizing alternative regimens that include VP-16, the most effective new agent.
authors.affiliation: Department of Obstetrics and Gynecology, University of Arizona, Tucson.
authors.forename: E A
authors.initials: EA
authors.lastname: Surwit
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003609:Dactinomycin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage; D011247:Pregnancy; D012307:Risk Factors; D014328:Trophoblastic Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D014594:Uterine Neoplasms; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D003609:Dactinomycin; D014750:Vincristine; D005047:Etoposide; D003520:Cyclophosphamide; D008727:Methotrexate