Recent advances in gestational trophoblastic disease

Advances in the last 20 years have led to a better understanding of the pro cess of gestational trophoblastic disease (GTD), and consequently to improv ed diagnosis, management, and prognosis. Patients with GTD should be regist ered at a trophoblastic disease center fur follow-up, and those with persis tent disease should receive chemotherapy, methotrexate, and folinic acid fo r low-risk disease, and EMACO (etoposide, actinomycin-D, methotrexate, vinc ristine, and cyclophosyhamide) for high-risk disease, without loss of ferti lity. Most patients with relapsing or resistant disease can be treated effe ctively with surgery and/or cisplatin in EP/EMA (etoposide, platinum-etopos ide, methotrexate, actinomycin-D) combination.