Abstract
Gestational trophoblastic disease (GTD) arises from abnormal placenta and is composed of a spectrum of premalignant to malignant disorders. Changes in epidemiology of GTD have been noted in various countries. In addition to histology, molecular genetic studies can help in the diagnostic pathway. Earlier detection of molar pregnancy by ultrasound and hCG has resulted in improving treatment effectiveness. Follow-up with hCG is essential for early diagnosis of gestational trophoblastic neoplasia (GTN) and the duration of hCG monitoring varies depending on histological type and regression rate. Low risk GTN (FIGO score < 7) is treated with single agent chemotherapy and may require additional agents, overall survival approaches 100%. High-risk GTN (FIGO score ≥ 7) is treated with multiagent chemotherapy, with or without adjuvant surgery for excision of resistant foci of disease, achieving a survival rate of approximately 90%. For cases with very high-risk scores, gentle induction chemotherapy helps reduce early deaths in patients with extensive tumor burden.
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