Evaluation of the criteria used to make the diagnosis of nonmetastatic gestational trophoblastic neoplasia.
The administration of chemotherapy following hydatidiform mole evacuation implies a diagnosis of trophoblastic neoplasia. A review of the literature and an analysis of a questionnaire sent to physicians treating trophoblastic disease shows that the criteria used to make this decision vary significantly. The factors that make it important to arrive at a consensus are discussed. Alternative investigations other than hCG that may distinguish neoplasia such as doppler flow ultrasound and magnetic resonance imaging are examined critically. A definition of neoplasia is presented that relates tumor load as measured by hCG to the length of hCG plateau. The changing criteria for distinguishing metastasis are discussed.
Department of Obstetrics & Gynecology, Yale University School of Medicine, New Haven, Connecticut 06510.
E I
EI
Kohorn
D006063:Chorionic Gonadotropin / Q000097:blood*; D003625:Data Collection; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006828:Hydatidiform Mole / Q000601:surgery; D008279:Magnetic Resonance Imaging; D009362:Neoplasm Metastasis; D011247:Pregnancy; D013997:Time Factors; D014328:Trophoblastic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy
D006063:Chorionic Gonadotropin