Persistent nonmetastatic gestational trophoblastic disease.
The management of GTD has developed as a result of an accurate and sensitive serologic marker, effective chemotherapeutic agents, and the judicious treatment of patients with evidence of persistence. Treatment and intervention guidelines are well established and will lead to a successful outcome for nearly all patients. Reproductive potential can be preserved and chemotherapy toxicity has been made quite manageable in the minority of patients requiring its administration. However, as demonstrated in the patient whose case is presented, violation or deviation from these guidelines for monitoring and intervention can lead to the unnecessary sacrifice of reproductive capability and the administration of potentially toxic multiagent chemotherapy regimens.
Kennedy
A W
AW
Department of Gynecology, Cleveland Clinic Foundation, OH 44195, USA.
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006063:Chorionic Gonadotropin / Q000378:metabolism; D004107:Dilatation and Curettage; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000601:surgery; D011247:Pregnancy; D014328:Trophoblastic Neoplasms / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D014594:Uterine Neoplasms / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*
D000970:Antineoplastic Agents; D006063:Chorionic Gonadotropin; D008727:Methotrexate