title: Evolution of a specialist gestational trophoblastic disease service with a major nursing component: the Sheffield, United Kingdom, experience.
abstract: OBJECTIVE
  To describe the evolution of a highly regarded and unique model of multidisciplinary care providing support, monitoring, and treatment for all gestational trophoblastic disease (GTD) patients referred to Sheffield Trophoblastic Disease Centre, 1 of the 3 United Kingdom (UK) supraregional GTD centers.
  
  
  BACKGROUND
  The UK GTD service was first established in 1973 and since its inception has centralized care for GTD patients and played a leading international role in developing therapies, management protocols, and biomarker assays with good outcomes for patients. The service preceded recent trends towards centralization for rare cancers in the U.K. In Sheffield the GTD team has evolved to become a true multidisciplinary team with a strong nursing component, which is set to expand in the future.
  
  
  RESULTS
  Centralization of care for GTD in the U.K. has been directly associated with the impressive results the service has achieved, with high cure rates (98-100%) and low (5-8%) chemotherapy rates. The addition of GTD nurse specialists has been beneficial to patients as they provide a communication link between patients and their clinicians and ensure that information, support, and advice is available for all GTD patients, both in hospital and at home.
  
  
  CONCLUSIONS
  The UK GTD service is an internationally renowned, multidisciplinary organization. The service achieves impressive clinical results and now features a strong nursing component. The addition of nurse specialists has enabled the team to offer both clinical and psychological care and means that specialist advice is available for patients and healthcare professionals involved in giving care to this patient group.
authors.forename: Jane
authors.initials: J
authors.lastname: Ireson
authors.forename: Kamaljit
authors.initials: K
authors.lastname: Singh
authors.forename: Sarah
authors.initials: S
authors.lastname: Gillett
authors.forename: Annie
authors.initials: A
authors.lastname: Hills
authors.forename: Jan
authors.initials: J
authors.lastname: Everard
authors.forename: Matthew
authors.initials: M
authors.lastname: Winter
authors.forename: Robert E
authors.initials: RE
authors.lastname: Coleman
authors.forename: John
authors.initials: J
authors.lastname: Tidy
authors.forename: Barry W
authors.initials: BW
authors.lastname: Hancock
mesh_terms: D005260:Female; D058006:General Practice; D031901:Gestational Trophoblastic Disease / Q000628:therapy*; D006176:Gynecology; D006801:Humans; D008495:Medical Oncology; D009720:Nurse Clinicians; D010348:Patient Care Team; D011247:Pregnancy; D013038:Specialization; D016896:Treatment Outcome; D006113:United Kingdom