Gullo Giuseppe, Satullo Marinì, Conti Eleonora, Ganduscio Silvia, Chitoran Elena, Kozinszky Zoltan, Kowalcze Karolina, Krysiak Robert, Billone Valentina, Cucinella Gaspare
Department of Obstetrics and Gynaecology, AOOR Villa Sofia-Cervello, University of Palermo, 90100 Palermo, Italy.
General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology, 022328 Bucharest, Romania.
Medicina (Kaunas). 2025 Sep 10;61(9):1642. doi: 10.3390/medicina61091642.
: Gestational trophoblastic diseases (GTDs) are rare premalignant and malignant conditions characterized by abnormal proliferation of trophoblastic tissue. They are often asymptomatic but may present with vaginal bleeding. GTDs include hydatidiform moles and gestational trophoblastic neoplasms (GTNs). Current research aims to improve diagnostic tools and treatment strategies to reduce cancer risk and improve survival. Increasing attention is being paid to immunotherapy and treatment personalization, with the goal of minimizing long-term side effects and enhancing quality of life. Less toxic therapies are ideal for low-risk patients to reduce drug-related toxicity. A narrative review was conducted to analyze studies from the last twenty years on the diagnosis, staging, and treatment of GTDs. Sources included PubMed, Scopus, and Cochrane Library, using keywords such as "trophoblastic disease," "hydatidiform mole," and "gestational trophoblastic neoplasia." In recent years, the clinical management of gestational trophoblastic disease (GTD) has made significant progress through diagnostic, prognostic, and therapeutic innovations. More sensitive imaging techniques and serial monitoring of serum β-hCG now allow early diagnosis of hydatidiform mole and gestational trophoblastic neoplasia (GTN), reducing the risk of complications and metastasis. In the last decade, GTD management has improved significantly, with better diagnostic techniques, standardized staging, and more effective treatments. However, challenges persist, including relapse management, long-term monitoring, and psychological support. Early diagnosis is key, with ultrasound being essential for detecting abnormalities in the first weeks of pregnancy. Staging follows FIGO and WHO criteria, considering hCG levels and metastasis. This review highlights recent advances in diagnostic tools, emerging therapies-including immunotherapy-and the need for personalized, less toxic treatment approaches to improve patient outcomes.
妊娠滋养细胞疾病（GTDs）是罕见的癌前和恶性疾病，其特征为滋养层组织异常增殖。它们通常无症状，但可能出现阴道出血。GTDs包括葡萄胎和妊娠滋养细胞肿瘤（GTNs）。当前的研究旨在改进诊断工具和治疗策略，以降低癌症风险并提高生存率。免疫疗法和治疗个性化越来越受到关注，目标是将长期副作用降至最低并提高生活质量。毒性较小的疗法对低风险患者是理想选择，可降低药物相关毒性。进行了一项叙述性综述，以分析过去二十年中关于GTDs诊断、分期和治疗的研究。来源包括PubMed、Scopus和Cochrane图书馆，使用了“滋养细胞疾病”、“葡萄胎”和“妊娠滋养细胞肿瘤”等关键词。近年来，妊娠滋养细胞疾病（GTD）的临床管理通过诊断、预后和治疗创新取得了显著进展。更敏感的成像技术和血清β-hCG的连续监测现在能够早期诊断葡萄胎和妊娠滋养细胞肿瘤（GTN），降低并发症和转移的风险。在过去十年中，GTD的管理有了显著改善，诊断技术更好、分期标准化且治疗更有效。然而，挑战依然存在，包括复发管理、长期监测和心理支持。早期诊断是关键，超声对于在妊娠最初几周检测异常至关重要。分期遵循国际妇产科联盟（FIGO）和世界卫生组织（WHO）标准，考虑hCG水平和转移情况。本综述强调了诊断工具的最新进展、新兴疗法（包括免疫疗法）以及采用个性化、毒性较小的治疗方法以改善患者预后的必要性。
