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 human chorionic gonadotrophin measurement following treatment is important for the detection of early relapse. Regimens for relapsed disease are usually successful, but need to be improved for the infrequent cases that develop multiple drug resistance. In this article the subtypes of GTD, rationale for treatment, surgery and drugs used in the condition are discussed.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.