Role of surgery and radiation therapy in the management of gestational trophoblastic disease.
Although sensitive human chorionic gonadotrophin (hCG) assays and advances in chemotherapy have assumed primary importance in the management of gestational trophoblastic disease (GTD), surgery and radiation therapy remain important in the overall management of patients. Management of molar pregnancies consists of surgical evacuation and subsequent monitoring. Hysterectomy may decrease the risk of post-molar trophoblastic disease. When incorporated into the primary management of malignant GTD, hysterectomy decreases chemotherapy requirements for patients with low-risk disease. Surgical intervention is frequently required to control complications of disease or as therapy to stabilize patients during chemotherapy. Salvage hysterectomy or other extirpative procedures may be integrated into the management of patients with chemorefractory disease. Interventional radiographical techniques are useful adjuncts to control haemorrhage from vaginal or pelvic metastases. Radiation therapy may also be combined with chemotherapy for the management of patients with brain metastases or, rarely, isolated metastases at other sites.
Soper
John T
JT
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Box 3079, Duke University Medical Center, Durham, NC 27710, USA. soper001@mc.duke.edu
D001932:Brain Neoplasms / Q000556:secondary / Q000601:surgery; D003131:Combined Modality Therapy / Q000379:methods; D003399:Craniotomy / Q000379:methods; D004107:Dilatation and Curettage / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D006828:Hydatidiform Mole / Q000601:surgery; D007044:Hysterectomy / Q000379:methods; D020883:Hysterotomy / Q000379:methods; D007751:Labor, Induced; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery; D009215:Myometrium / Q000601:surgery; D011247:Pregnancy; D014594:Uterine Neoplasms / Q000601:surgery