Recent trends in treatment of choriocarcinoma.

During the period 1959 to 1966 80 cases of trophoblastic malignancy and over 500 cases of hydatidiform mole were treated in the University Unit at the Kandang Kerbau Hospital, Singapore, as part of a prospective study of trophoblastic diseases. This paper reports the experience and results obtained in the management of the 80 cases of trophoblastic malignancy up to June 1966. All cases have been managed under our personal supervision. Operation and necropsy specimens have been examined and classified by one of us (W. S. H. T.). Definition, Diagnosis, and Classification.-Choriocarcinoma is defined as the presence of chorionic growth outside the normal bounds of the maternal decidua, with manifestations of malignancy. The diagnosis of malignancy was based on (a) the histological demonstration of massive aggregates of trophoblasts within the depths of the myometrium or in any extrauterine site associated with tissue destruction and haemorrhage, and (b) the radiological demonstration of persisting opacities in the lung fields consistent with metastatic choriocarcinoma and supported by a positive test for chorionic gonadotrophin. The classification adopted in the 80 cases was that advocated by Tow (1965). All chorionic malignancies were termed " choriocarcinoma" and prefixed by "villous"