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