Treatment of Gestational Trophoblastic Disease - Review of Literature

Gestational trophoblastic disease (GTD) is characterized by abnormal proliferation of pregnancy-associated trophoblastic tissue with malignant potential. GTD covers a spectrum of tumors and tumor-like conditions and may occur in a benign form as hydatiform mole or as malignancy in the form of invasive mole or choriocarcinoma. GTD has become a curable malignant disease since the introduction of chemotherapy. Optimal therapy in this group of diseases rests in the correct diagnosis, assessing their risk for malignant behavior using prognostic scoring systems and administering appropriate treatment. Their rarity makes it imperative that these patients are treated in special centres by experts. Benign moles are treated surgically with evacuation of the uterus or hysterectomy. In malignant gestational trophoblastic disease, chemotherapy is the treatment of choice; single agent for non-metastatic and low-risk metastatic disease and a combination chemotherapy for high-risk metastatic disease. Judicious use of surgery and radiotherapy in these cases will improve the survival rate. With appropriate treatment, the cure rates approach 100% in the low-risk group, and 80% to 85% in the high risk group. By applying the aquired knowledge and experiences, we could not accept to lose any patient because of gestational trophoblastic diseases. Acta Medica Medianae 2010; 49(1):64-69.