title: Management of Chemoresistant and Quiescent Gestational Trophoblastic Disease.
abstract: Gestational trophoblastic neoplasia (GTN) is highly chemosensitive and has a high cure rate. Since the introduction of chemotherapy, reliable measurement of human chorionic gonadotropin (hCG) levels, and individualised risk-based therapy into the management of GTN, almost all low-risk and more than 80 % of high-risk GTN cases are curable. However, approximately 25 % of high-risk GTN developed resistance to chemotherapy or relapsed after completion of initial therapy, which often necessitate salvage combination chemotherapy. On the other end of the spectrum, a proportion of patients with gestational trophoblastic disease (GTD) have persistently low levels of hCG, without clinical or radiological evidence of disease, a condition called quiescent GTD. Recently, measurement of hyperglycosylated hCG has been proposed for the management of patients with quiescent GTD. Although representing a small proportion of GTD cases, the management of patients with chemoresistant and quiescent GTD often poses challenges to medical practitioners.
authors.affiliation: Department of Obstetrics and Gynecology, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, Hong Kong SAR.
authors.forename: Siew-Fei
authors.initials: SF
authors.lastname: Ngu
authors.affiliation: Department of Obstetrics and Gynecology, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, Hong Kong SAR.
authors.forename: Karen K L
authors.initials: KK
authors.lastname: Chan
keywords: Chemoresistant; Gestational trophoblastic disease; Gestational trophoblastic neoplasia; Human chorionic gonadotropin; Hyperglycosylated human chorionic gonadotropin; Quiescent gestational trophoblastic disease