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. 2014 Jan 4;3(1):84-90.
doi: 10.1007/s13669-013-0071-6. eCollection 2014.

Management of Chemoresistant and Quiescent Gestational Trophoblastic Disease

Free PMC article

Management of Chemoresistant and Quiescent Gestational Trophoblastic Disease

Siew-Fei Ngu et al. Curr Obstet Gynecol Rep. .
Free PMC article


Gestational trophoblastic neoplasia (GTN) is highly chemosensitive and has a high cure rate. Since the introduction of chemotherapy, reliable measurement of human chorionic gonadotropin (hCG) levels, and individualised risk-based therapy into the management of GTN, almost all low-risk and more than 80 % of high-risk GTN cases are curable. However, approximately 25 % of high-risk GTN developed resistance to chemotherapy or relapsed after completion of initial therapy, which often necessitate salvage combination chemotherapy. On the other end of the spectrum, a proportion of patients with gestational trophoblastic disease (GTD) have persistently low levels of hCG, without clinical or radiological evidence of disease, a condition called quiescent GTD. Recently, measurement of hyperglycosylated hCG has been proposed for the management of patients with quiescent GTD. Although representing a small proportion of GTD cases, the management of patients with chemoresistant and quiescent GTD often poses challenges to medical practitioners.

Keywords: Chemoresistant; Gestational trophoblastic disease; Gestational trophoblastic neoplasia; Human chorionic gonadotropin; Hyperglycosylated human chorionic gonadotropin; Quiescent gestational trophoblastic disease.

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