Gestational trophoblastic disease Treatment

Gestational trophoblastic disease

    * Introduction
    * Diagnosis
    * Treatment
back Treatment
Patients with gestational trophoblastic disease do not require medical therapy. Since 20% of patients with malignant disease develops hidatiforma Mola, Mola hidatiforma as persistence with or without metastases suggested the use of prophylactic doses of methotrexate in patients noncompliante. However, observation and evaluation of patients weekly serum HCG level is preferable. Only patients with elevated levels of the plate or require chemotherapy.
Patients with metastatic mole nonmetastatica or decreased risk but are treated with single agent chemotherapy, methotrexate is preferred. However actinomicina D can be used in patients with poor liver function. During treatment, serum HCG level is monitored weekly. It manages a number of additional chemotherapy after the normal level of serum HCG.
Surgical therapy: Hysterectomy may be needed if an uncontrolled vaginal bleeding. Hysterectomy may reduce the total number of sets needed to achieve remission chemotherapy. Hypogastric or uterine artery ligation or embolization of tumor vessels may be useful to control bleeding. Hepatic artery embolization was successfully used to control bleeding in liver metastases. Craniotomy may be needed to control bleeding and decompresiona. Resection of solitary metastasis or disease of miometru can help to achieve remission.
Prognosis: Nonmetastazica gestational trophoblastic disease has a cure rate of 100% with chemotherapy. High-risk metastatic disease has a 75% healing cure by chemotherapy. After 12 months of normal hCG levels less than 1% of patients with this disease shows recurrent.