A conservative approach in persistent low-level elevation of serum beta-human chorionic gonadotropin following chemotherapy for gestational trophoblastic neoplasia.
OBJECTIVE
To question whether patients with persistent low-level elevation of beta-human chorionic gonadotropin (beta-hCG) following chemotherapy for gestational trophoblastic neoplasia can be managed conservatively.


METHODS
A retrospective study of all patients requiring chemotherapy for gestational trophoblastic neoplasia (GTN), treated in Sheffield from 1994 to 2007, evaluating those for whom a clinical decision was made to stop chemotherapy when the serum beta-hCG level remained elevated.


RESULTS
Of the 350 patients requiring chemotherapy, 17 had persistently elevated beta-hCG at the time chemotherapy was stopped. The range of elevation was 4-43 IU/L (mean, 7.5) and duration 3-32 weeks (mean, 10.7). In 16 patients, beta-hCG became undetectable and further treatment was not required; in only 1 patient did the level suddenly become elevated (from 12 to 77 IU/L after 3 months), requiring further and curative chemotherapy.


CONCLUSIONS
These results suggest that a conservative but watchful approach can be taken for persistent low-level elevation (up to 40 IU/L) of serum beta-hCG following chemotherapy.
Boafo-Yirenki
Melanie
M
Sheffield Trophoblast Centre, Weston Park Hospital, Whitham Road, Sheffield, United Kingdom.
Everard
Janet
J
Tidy
John
J
Hancock
Barry W
BW
D000970:Antineoplastic Agents / Q000627:therapeutic use; D002822:Choriocarcinoma / Q000556:secondary; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000097:blood* / Q000188:drug therapy*; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary; D011247:Pregnancy; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000556:secondary
D000970:Antineoplastic Agents; D018997:Chorionic Gonadotropin, beta Subunit, Human