Gestational trophoblastic disease II: classification and management of gestational trophoblastic neoplasia.
Gestational trophoblastic neoplasia (GTN) includes invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor. The overall cure rate in treating these tumors is currently >90%. Thorough evaluation and staging allow selection of appropriate therapy that maximizes chances for cure while minimizing toxicity. Nonmetastatic (stage I) and low-risk metastatic (stages II and III, score <7) GTN can be treated with single-agent chemotherapy resulting in a survival rate approaching 100%. High-risk GTN (stages II-IV, score ≥7) requires initial multiagent chemotherapy with or without adjuvant radiation and surgery to achieve a survival rate of 80-90%.
Lurain
John R
JR
John I. Brewer Trophoblastic Disease Center, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. jlurain@nmff.org
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis; D006063:Chorionic Gonadotropin / Q000032:analysis; D003609:Dactinomycin / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000097:blood / Q000145:classification* / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D002955:Leucovorin / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D009367:Neoplasm Staging / Q000379:methods; D011247:Pregnancy; D012074:Remission Induction; D017211:Treatment Failure
D014408:Biomarkers, Tumor; D006063:Chorionic Gonadotropin; D003609:Dactinomycin; D002955:Leucovorin; D008727:Methotrexate