Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2014 Jan 4;3(1):84-90.
doi: 10.1007/s13669-013-0071-6. eCollection 2014.

Management of Chemoresistant and Quiescent Gestational Trophoblastic Disease

Affiliations
Free PMC article
Review

Management of Chemoresistant and Quiescent Gestational Trophoblastic Disease

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

Abstract

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.

Similar articles

See all similar articles

Cited by 5 articles

References

    1. Ngan HY, Kohorn EI, Cole LA, Kurman RJ, Kim SJ, Lurain JR, et al. Trophoblastic disease. Int J Gynaecol Obstet. 2012;119(Suppl 2):S130–6. doi: 10.1016/S0020-7292(12)60026-5. - DOI - PubMed
    1. Alazzam M, Tidy J, Osborne R, Coleman R, Hancock BW, Lawrie TA. Chemotherapy for resistant or recurrent gestational trophoblastic neoplasia. Cochrane Database Syst Rev. 2012;12:CD008891. - PubMed
    1. Cole LA, Muller CY. Hyperglycosylated hCG in the management of quiescent and chemorefractory gestational trophoblastic diseases. Gynecol Oncol. 2010;116(1):3–9. doi: 10.1016/j.ygyno.2009.09.028. - DOI - PubMed
    1. Newlands ES. The management of recurrent and drug-resistant gestational trophoblastic neoplasia (GTN) Best Pract Res Clin Obstet Gynaecol. 2003;17(6):905–23. doi: 10.1016/S1521-6934(03)00092-0. - DOI - PubMed
    1. Lybol C, Sweep FC, Harvey R, Mitchell H, Short D, Thomas CM, et al. Relapse rates after two versus three consolidation courses of methotrexate in the treatment of low-risk gestational trophoblastic neoplasia. Gynecol Oncol. 2012;125(3):576–9. doi: 10.1016/j.ygyno.2012.03.003. - DOI - PubMed

LinkOut - more resources

Feedback