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Gestational Trophoblastic Disease

Soper, John T. MD

doi: 10.1097/01.AOG.0000224697.31138.a1
Clinical Expert Series

This review summarizes the primary management of molar pregnancies, surveillance after evacuation, and the evaluation and management of malignant gestational trophoblastic neoplasia (GTN). Most women with gestational trophoblastic disease can be successfully managed with preservation of their normal reproductive function. It is important to manage molar pregnancies properly to minimize acute complications and identify malignant sequelae promptly. Current International Federation of Gynecology and Obstetrics (FIGO) guidelines for making the diagnosis and staging of GTN allow uniformity for reporting results of treatment. It is important to individualize treatment for women with malignant GTN based upon risk factors, using less toxic therapy for patients with low-risk disease and aggressive multiagent therapy for those with high-risk disease. Patients with malignant GTN should be managed in consultation with an individual experienced in the complex, multimodality treatment of these patients.

Gestational trophoblastic disease is a spectrum of diseases affecting young women, which can usually be treated without loss of reproductive capacity. Supplemental Digital Content is Available in the Text.

From the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina.

Corresponding author: John T. Soper, MD, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Box 3079, Duke University Medical Center, Durham, NC 27710; e-mail: soper001@mc.duke.edu.

Financial Disclosure Dr. Soper was a Reed Medical Education–Oncology World Symposium Advisory Board Member, 2005–2006.

Continuing medical education is available online atwww.greenjournal.org

© 2006 The American College of Obstetricians and Gynecologists