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Treatment of gestational trophoblastic disease

The choice of treatment depends on the extent of the disease and hCG level (WHO score).

Treatment for mole and choriocarcinoma

  • Uterine evacuation. The uterine cavity is completely evacuated and all material sent for histological examination.
  • Serum hCG is monitored every other week for 8 weeks. With normal serum hCG (<1 IE) after 8 weeks, hCG is monitored monthly for 6 months. For elevated hCG after 8 weeks, s-hCG is monitored every other week to normalization, thereafter monthly follow-up.
  • Re-evacuation should not be carried out.
  • Birth control usually in the form of birth control pills is recommended for 6 months, thereafter the woman may become pregnant again. 

The Norwegian Radium Hospital should be contacted if:

  • increasing hCG levels after evacuation. Control test should be taken after 1 week.
  • serum hCG plateau for more than 4 weeks
  • histological diagnosis of choriocarcinoma or placental-site trophoblastic tumor
  • confirmation of metastasic disease 

Determining factors for choosing chemotherapy (5,6):

  • Course of serum hCG values over time
  • Choriocarcinoma, placental-site tumor and metastatic disease 
  • WHO risk score and FIGO stage

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