Treating gestational trophoblastic disease.
BACKGROUND
Gestational trophoblastic disease is one of the few human malignancies that is curable, even in advanced stages of the disease. However, appropriate management and follow-up are essential components in curing this disease.


METHODS
Observational, retrospective and prospective studies evaluating the efficacy of medical and surgical management of gestational trophoblastic disease were analyzed to provide a comprehensive review of current and new treatment modalities. We searched PubMed, Medline and the Library of Congress from January 1965 to January 2010.


RESULTS
The reader will obtain information on how to classify gestational trophoblastic neoplasia (GTN) into low- and high-risk groups, as well as learn the medical and surgical management of low- and high-risk GTN and recurrent GTN. The effectiveness of treatment regimens and subsequent fertility is also reviewed.


CONCLUSIONS
GTN is highly responsive to chemotherapy. However, surgery is an important adjunct in select cases. Even in advanced-stage or recurrent disease, cure can be achieved and fertility preserved.
Brigham and Women's Hospital/Dana Farber Cancer Institute, Department of Obstetrics and Gynecology, New England Trophoblastic Disease Center, Harvard Medical School, Boston, MA 02115, USA.
Noah
N
Rodriguez
Donald P
DP
Goldstein
Ross S
RS
Berkowitz
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D005298:Fertility; D031901:Gestational Trophoblastic Disease / Q000473:pathology / Q000628:therapy*; D006801:Humans; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011247:Pregnancy; D012307:Risk Factors; D016879:Salvage Therapy / Q000379:methods; D016896:Treatment Outcome
D000970:Antineoplastic Agents