Nonmetastatic gestational trophoblastic neoplasia. Controversies in definition and management.

The difficulties with the current definition of nonmetastatic gestational trophoblastic neoplasia are discussed in relation to the evaluation of length of time, amount of human chorionic gonadotropin elevation and histologic criteria used to make the diagnosis. Evaluation of the patient is described, and the effect of more-sophisticated methods of investigation on staging and on therapy is placed in perspective. More-effective, less-toxic and more-efficient chemotherapy delivery systems are available today.