Current views on the management of trophoblastic tumors

Gestational trophoblastic disease has been recognized as a form of abnormal pregnancy as early as 1600 AD, and choriocarcinoma was the first cancer to be cured with chemotherapy even in the presence of distant and widespread metastases. Important advances in the past include the standardization of terminology, the concept of assignment of risk and the use of staging systems, the centralization of care and the establishment of regional registries, and of course the development of the radioimmunoassay for the beta subunit of human chorionic gonadotropin. The current views on the management of this disease recognizes the need for a multidisciplinary approach, with chemotherapy remaining at the forefront but also utilizing newer diagnostic techniques when necessary, and keeping in mind the crucial role that surgery can play especially in resistant cases. At the same time, the importance of basics such as careful follow up after evacuation of a hydatidiform mole cannot be overemphasized. There will be a continual refinement of the chemotherapy regimes used, and the aim is to achieve a similar level of response with decreased toxicity to the patient.