[New trends in trophoblastic disease]

In Japan, population-based trophoblastic disease registries were set up in the 1974s by the Registration Committee for Trophoblastic Disease (Japan Society of Obstet. & Gynecol.). The results indicate the following. 1. The incidence rates for trophoblastic disease show that the incidence of hydatidiform mole has been decreasing year by year from 10.2 to 5.9 throughout the observation period 1979-1986. But the incidence for hydatidiform mole per 1,000 pregnancies was from 1.83 to 1.91, and that per 1,000 deliveries was also from 2.84 to 2.93 throughout the observation period. The incidence of choriocarcinoma has also been decreasing year by year from 0.31 to 0.13 throughout the observation period. The frequency of choriocarcinoma after hydatidiform mole with complete remission was 0.32% (4/1, 171), but that after hydatidiform mole with no remission was 3.08% (4/130). The high risk groups for choriocarcinoma were hydatidiform mole over 40 years old, metastatic mole, and invasive mole. Five-year survival rate of choriocarcinoma with no metastatic foci was 100%, and that of metastatic choriocarcinoma was 59.2%. For cases treated with surgery combined with chemotherapy, 80.0 per cent of the cases survived 5 years compared with 71.4 per cent of the cases treated with chemotherapy alone and 67.7 per cent of the cases treated with surgery alone. The mortality for choriocarcinoma per 100,000 female population has been decreasing year by year from 0.123 to 0.065 throughout the observation period.