Early detection of persistent trophoblastic tumour by serum human chorionic gonadotrophin monitoring after molar pregnancy

Chin Med J (Engl). 1999 Mar;112(3):260-3.


Objective: To study the outcome of a multi-centred post-molar pregnancy serum human chorionic gonadotrophin (hCG) surveillance programme.

Methods: Patients recruited into the multi-centred post-molar serum hCG surveillance programme between 1988 and 1996 were studied. The clinical data were obtained from medical records and computer database.

Results: There were 616 patients in the study. Twenty-five (11%) of 224 patients with molar pregnancy and 28 (7%) of 392 patients with partial molar pregnancy were diagnosed to have persistent trophoblastic tumour (PTT) requiring chemotherapy. Of the 53 patients treated for PTT, 58.5% received intravenous methotrexate (MTX), 22.6% received both MTX and actinomycin D, and 19% received CHAMOC, a multiple chemotherapeutic regimen. Four patients receiving single drug had to change the regimen because of poor response, and all recovered and remained well. There were 3 cases of recurrence, one in each group of patients receiving single, dual or multiple agents. One patient died because of treatment complication. The rest were well with a mean follow-up of 42 months.

Conclusions: Post-molar serum hCG surveillance is important to detecting persistent trophoblastic activity. Early treatment of PTT by the appropriate chemotherapy has a near hundred percent cure and prevents the progression of PTT into more advanced trophoblastic malignancy such as choriocarcinoma.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Antibiotics, Antineoplastic / therapeutic use
  • Antineoplastic Agents / therapeutic use
  • Chorionic Gonadotropin / blood*
  • Dactinomycin / therapeutic use
  • Female
  • Humans
  • Hydatidiform Mole / blood*
  • Methotrexate / therapeutic use
  • Middle Aged
  • Pregnancy
  • Trophoblastic Neoplasms / blood
  • Trophoblastic Neoplasms / diagnosis*
  • Trophoblastic Neoplasms / drug therapy
  • Uterine Neoplasms / blood
  • Uterine Neoplasms / diagnosis*
  • Uterine Neoplasms / drug therapy


  • Antibiotics, Antineoplastic
  • Antineoplastic Agents
  • Chorionic Gonadotropin
  • Dactinomycin
  • Methotrexate