SURGICAL THERAPY FOR GESTATIONAL TROPHOBLASTIC DISEASE

Current successful therapy for women with gestational trophoblastic disease (GTD) is based upon the use of sensitive assays for human chorionic gonadotropin to monitor disease status and individualized application of chemotherapy based upon recognized risk factors. However, surgical therapy continues to play a role in the management of GTD. Suction dilation and curettage and hysterectomy are used for primary therapy for hydatidiform mole. Hysterectomy may be used as an adjunct to the primary management of selected patients with malignant GTD. Other extirpative procedures, such as thoracotomy, may be integrated into the management of drug-resistant disease.