Current management of gestational trophoblastic disease

Gestational trophoblastic disease incorporates a spectrum of disorders ranging from benign to malignant subtypes. At one end of the condition, hCG level monitoring is all that is required, whereas other patients require combination chemotherapy regimens and surgery to cure the disease. The diagnosis can have profound effects on both the patient and her family and it is essential this is recognised and managed appropriately. Although rare, clinicians in non-specialist units are expected to inform patients of their diagnosis and explain the management steps prior to being referred to a specialised Trophoblastic centre and unfortunately, patients may be given inaccurate or incomplete information and use the Internet as their primary source of information. This article intends to explain the diagnosis itself (incidence, genetics, subtypes), clinical presentation and management, whilst answering some of the most commonly encountered questions asked by affected patients.