[Place of surgery in the management of gestational trophoblastic tumors]

Gestational trophoblastic tumors are authentic malignant tumors of the conception. They are mostly chemosensitive. For young women, the place of the surgery seems now restricted and more and more codified. Hysterectomy keeps a certain interest for women who do not wish to preserve their fertility. Hysterectomy limits then the complications of chemotherapy. It optimizes the chances of recovery without recurrence. If chemotherapy must nevertheless be carried out, hysterectomy decreases the necessary number of cures to obtain complete remission of the disease. Surgery is also indispensable to chemoresistant tumors. It allows exeresis of localized residual sites or isolated metastases. Other indications for surgery include uncontrollable vaginal or intra-abdominal bleedings and placental site trophoblastic tumors.