title: Late spontaneous resolution of persistent molar pregnancy.
abstract: OBJECTIVE
  To determine the outcome of women with persistently raised but falling human chorionic gonadotrophin (hCG) levels 6 months after surgical evacuation of a molar pregnancy.
  
  
  METHODS
  An 11-year retrospective review.
  
  
  METHODS
  The United Kingdom supra-regional trophoblastic disease treatment centres at Weston Park Hospital (Sheffield) and Charing Cross Hospital (London).
  
  
  METHODS
  Women with raised but falling serum human chorionic gonadotrophin (hCG) levels 6 months after evacuation of a molar pregnancy.
  
  
  METHODS
  Retrospective case note review of eligible women identified by the electronic databases held at each supra-regional centre.
  
  
  METHODS
  The proportion of women that attain normal hCG levels spontaneously without chemotherapy. In addition, rates of gestational trophoblastic neoplasia (GTN), drug resistance, disease relapse and overall survival are reported.
  
  
  RESULTS
  Thirty-five women with molar pregnancy and raised but falling serum hCG levels continued surveillance 6 months after evacuation. Levels of hCG in 30 of the patients (86%) fell to normal levels spontaneously. One woman defaulted follow up prior to hCG normalisation (3%) and the remaining four women (11%) were treated with chemotherapy due to a plateau or rise in serum hCG levels indicating GTN. All treated women were successfully salvaged by either first (n = 1) or second line (n = 2) chemotherapy or found to have persistently raised low level hCG of uncertain clinical relevance (n = 1). No women developed relapsed disease and overall survival was 100%.
  
  
  CONCLUSIONS
  Women with a molar pregnancy and a raised but falling hCG level beyond 6 months from uterine evacuation can be safely observed with regular hCG monitoring and can usually avoid potentially toxic chemotherapy.
  
  
  CONCLUSIONS
  Women with treated molar pregnancy may avoid chemotherapy if 6-month hCG levels are raised but falling.
authors.affiliation: Sheffield Centre for Trophoblastic Disease, Sheffield Cancer Research Centre, Weston Park Hospital, Sheffield, UK.
authors.forename: F
authors.initials: F
authors.lastname: Taylor
authors.affiliation: Charing Cross Gestational Trophoblastic Disease Centre, Department of Medical Oncology, Charing Cross Hospital Campus of Imperial College London, London, UK.
authors.forename: D
authors.initials: D
authors.lastname: Short
authors.affiliation: Charing Cross Gestational Trophoblastic Disease Centre, Department of Medical Oncology, Charing Cross Hospital Campus of Imperial College London, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Harvey
authors.affiliation: Sheffield Centre for Trophoblastic Disease, Sheffield Cancer Research Centre, Weston Park Hospital, Sheffield, UK.
authors.forename: M C
authors.initials: MC
authors.lastname: Winter
authors.affiliation: Sheffield Centre for Trophoblastic Disease, Sheffield Cancer Research Centre, Weston Park Hospital, Sheffield, UK.
authors.forename: J
authors.initials: J
authors.lastname: Tidy
authors.affiliation: Sheffield Centre for Trophoblastic Disease, Sheffield Cancer Research Centre, Weston Park Hospital, Sheffield, UK.
authors.forename: B W
authors.initials: BW
authors.lastname: Hancock
authors.affiliation: Charing Cross Gestational Trophoblastic Disease Centre, Department of Medical Oncology, Charing Cross Hospital Campus of Imperial College London, London, UK.
authors.forename: P M
authors.initials: PM
authors.lastname: Savage
authors.affiliation: Charing Cross Gestational Trophoblastic Disease Centre, Department of Medical Oncology, Charing Cross Hospital Campus of Imperial College London, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: Sarwar
authors.affiliation: Charing Cross Gestational Trophoblastic Disease Centre, Department of Medical Oncology, Charing Cross Hospital Campus of Imperial College London, London, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Seckl
authors.affiliation: Sheffield Centre for Trophoblastic Disease, Sheffield Cancer Research Centre, Weston Park Hospital, Sheffield, UK.
authors.forename: R E
authors.initials: RE
authors.lastname: Coleman
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006063:Chorionic Gonadotropin / Q000378:metabolism; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000188:drug therapy / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009365:Neoplasm Regression, Spontaneous; D011247:Pregnancy; D016879:Salvage Therapy / Q000379:methods; D014594:Uterine Neoplasms / Q000188:drug therapy / Q000601:surgery*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D006063:Chorionic Gonadotropin
keywords: Complete mole; human chorionic gonadotrophin; hydatidiform; molar pregnancy; monitoring; partial mole