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Chemotherapy Research and Practice
Volume 2011 (2011), Article ID 806256, 12 pages
http://dx.doi.org/10.1155/2011/806256
Review Article

Current Chemotherapeutic Management of Patients with Gestational Trophoblastic Neoplasia

Brigham and Women's Hospital and Dana-Farber Cancer Institute, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, New England Trophoblastic Disease Center, Harvard Medical School, Boston, MA 02115, USA

Received 20 January 2011; Accepted 1 March 2011

Academic Editor: Kazuo Tamura

Copyright © 2011 Taymaa May et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Gestational trophoblastic neoplasia (GTN) describes a heterogeneous group of interrelated lesions that arise from abnormal proliferation of placental trophoblasts. GTN lesions are histologically distinct, malignant lesions that include invasive hydatidiform mole, choriocarcinoma, placental site trophoblastic tumor (PSTT) and epithelioid trophoblastic tumor (ETT). GTN tumors are generally highly responsive to chemotherapy. Early stage GTN disease is often cured with single-agent chemotherapy. In contrast, advanced stage disease requires multiagent combination chemotherapeutic regimens to achieve a cure. Various adjuvant surgical procedures can be helpful to treat women with GTN. Patients require careful followup after completing treatment and recurrent disease should be aggressively managed. Women with a history of GTN are at increased risk of subsequent GTN, hence future pregnancies require careful monitoring to ensure normal gestational development. This article will review the workup, management and followup of women with all stages of GTN as well as with recurrent disease.