Gestational trophoblastic disease (GTD) is a group of interrelated tumors that arise
from abnormal fertilization events and include both benign conditions (complete hydatidiform
mole (CM) and partial hydatidiform mole (PM), placental site nodule), potentially
malignant conditions (atypical placental site nodule APSN), as well as malignant conditions
(invasive mole (IM), choriocarcinoma (CA), placental-site trophoblastic tumor (PSTT),
and epithelioid trophoblastic tumor (ETT)). These malignancies are collectively referred
to as gestational trophoblastic neoplasia (GTN). While the majority of GTN occurs
after a molar pregnancy (50%), they can arise after any gestational event with 25%
arising after miscarriage or tubal pregnancy and 25% after term or preterm pregnancies
[
[1]
]. Unlike most malignancies, GTN can be cured even in the presence of metastatic disease.
With the exception of PSTT and ETT, GTD arises from cytotrophoblasts and syncytiotrophoblasts,
and produce abundant amounts of human chorionic gonadotropin (hCG), which serves as
an excellent tumor marker for diagnosis, monitoring of response, and follow-up to
detect recurrence. Given the rarity of this disease, management and treatment recommendations
are commonly informed by data from small, retrospective single institution or collaborative
studies, small prospective studies, meta-analyses, and expert opinion [
[2]
]. The purpose of this document is to provide a comprehensive reference for the epidemiology,
management and outcomes of GTD/GTN. We carried out a systematic review of English
language studies, identified through a search of MEDLINE/Pubmed, Cochrane Library,
and Google Scholar from inception until June 2021. Using the terms gestational trophoblastic
disease, gestational trophoblastic neoplasia, molar pregnancy, human chorionic gonadotropin,
chemotherapy, we generated the references for this review and accompanying recommendations.To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 19, 2021
Accepted:
October 4,
2021
Received in revised form:
September 28,
2021
Received:
July 15,
2021
Footnotes
☆This practice statement has been endorsed by the American College of Obstetricians and Gynecologists (ACOG).
Identification
Copyright
© 2021 Published by Elsevier Inc.
