Intensive inpatient therapy and survival in gestational trophoblastic disease

Metastatic gestational trophoblastic disease may be categorized into "good prognosis" and "poor prognosis" groups on the basis of the level of the pretreatment human chorionic gonadotropin titer, the location of metastases, the duration of disease, type of antecedent gestation, and the response of prior therapy. One hundred twenty-six patients with metastatic disease were treated from 1966 through 1979. All patients were treated as inpatients. Sixty-three "good prognosis" patients required an average of 65 days of intensive inpatient chemotherapy and all achieved sustained remission. Sixty-three "poor prognosis" patients were treated. Thirty-eight patients achieved sustained remission after an average of 112 days of intensive chemotherapy. Twenty-five patients (40%) succumbed to disease, after an average of 162 days of therapy. The probability of successful outcome of therapy falls rapidly after 150 days of treatment. Toxicity and deaths are reviewed.