Abstract
Gestational trophoblastic neoplasia (GTN) is the term to describe a set of malignant placental diseases, including invasive mole, choriocarcinoma, placental site trophoblastic tumor and epithelioid trophoblastic tumor. Both invasive mole and choriocarcinoma respond well to chemotherapy, and cure rates are greater than 90%. Since the advent of chemotherapy, low-risk GTN has been treated with a single agent, usually methotrexate or actinomycin D. Cases of high-risk GTN, however, should be treated with multiagent chemotherapy, and the regimen usually selected is EMA-CO, which combines etoposide, methotrexate, actinomycin D, cyclophosphamide and vincristine. This study reviews the literature about GTN to discuss current knowledge about its diagnosis and treatment.
Highlights
Gestational trophoblastic neoplasia (GTN) is the term used to describe malignant lesions that originate in the chorionic villi and the extravillous trophoblast
The objective of this paper is to present an update of clinical aspects, diagnosis and treatment of GTN in order to guide the Brazilian gynecologists and obstetricians on the major advances in the management of patients affected by this neoplasm of pregnancy
A search was conducted in the PubMed and the Cochrane Library databases from January 2004 to June 2014, using the term “gestational trophoblastic neoplasia”
Summary
Gestational trophoblastic neoplasia (GTN) is the term used to describe malignant lesions that originate in the chorionic villi and the extravillous trophoblast. This designation includes four different clinical entities, each with different degrees of proliferation, invasion and dissemination: invasive mole (IM), choriocarcinoma (CCA), placental site trophoblastic tumor (PSTT) and epithelioid trophoblastic tumor (ETT)[1,2,3,4,5]. These diseases, characterized by high levels of human chorionic gonadotropin (hCG), are highly responsive to chemotherapy (ChT) and have cure rates greater than 90%4. The first-line treatment in these cases is surgery, in no metastatic cases[4]
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