Treatments for gestational trophoblastic disease

Abstract

Gestational trophoblastic disease (GTD) is a relatively rare but important group of benign and malignant disorders that affect women of child-bearing potential. Most cases are now diagnosed earlier than previously owing to advances in our knowledge of the disease and accuracy of ultrasonography, combined with the high analytical sensitivity of human chorionic gonadotrophin assays, although occasionally patients with metastases present at a late stage with life-threatening complications. Early diagnosis and referral to a specialist center for further management is vital so that patients can receive the optimal standard of care. Patients can be grouped into high- and low-risk categories using well-established prognostic scoring systems, enabling the minimum appropriate treatment to be recommended. Chemotherapy regimens for the disease are now well established, so that for the vast majority, GTD is a curable condition, and patients can be reassured that fertility is normally preserved. Regular follow-up by h...