Objective: Evaluation of the treatment of patients with gestational trophoblastic disease.
Setting: Academic Medical Centre, Amsterdam.
Design: Descriptive.
Method: Clinical data from all patients treated between 1983 and 1992 were collected.
Results: Thirty-one patients were treated in this period. Eighteen patients had persistent trophoblast after a molar pregnancy, 7 had choriocarcinoma after a normal pregnancy and in 6 patients the obstetrical history was unclear. The initial treatment strategy was chosen on the basis of prognostic factors; low-risk patients received mono-chemotherapy (Methotrexate) and high-risk patients were treated with polychemotherapy (EMA/CO). In 15 cases adjuvant therapy was necessary. Complete remission was achieved in 29 patients, 2 patients died. The adverse effects of the chemotherapy were generally mild.
Conclusion: Persistent trophoblastic disease has an unpredictable presentation and course. Therefore treatment should preferably be given in a reference centre.