title: Asian approaches in the treatment of trophoblastic disease.
abstract: The cure of trophoblastic disease depends on early recognition and appropriate chemotherapy. In many areas in Asia, doctors face the problems of insufficient funds and poor patient compliance with follow-up. In such situations, the maximum returns for the minimum input would consist of: 1. Routine ultrasound diagnosis for irregular vaginal bleeding associated with amenorrhea; 2. In hydatidiform mole, hysterectomy for women above 40 and those who have completed their families; prostaglandin and suction curettage for evacuation; 3. Prophylactic methotrexate-folinic acid, or dactinomycin or 5-FU for high-risk cases; 4. Follow-up by the simplified regimen using hCG test kits; 5. Chemotherapy with hysterectomy for choriocarcinoma, whether localized in the uterus or metastatic: if the uterus is to be conserved, there must be a good reason; 6. Multiagent chemotherapy as first line in all high-risk cases; and 7. In view of the excellent results with 5-FU in China, investigation of this drug elsewhere, initially in metastatic mole.
authors.affiliation: Teoh Clinic for Women, Shaw Centre, Singapore.
authors.forename: E S
authors.initials: ES
authors.lastname: Teoh
mesh_terms: D001208:Asia; D006063:Chorionic Gonadotropin / Q000097:blood; D003431:Cross-Cultural Comparison; D005260:Female; D006801:Humans; D011247:Pregnancy; D011379:Prognosis; D014328:Trophoblastic Neoplasms / Q000628:therapy*; D014594:Uterine Neoplasms / Q000628:therapy*
chemical_list: D006063:Chorionic Gonadotropin