Persistent chest opacity in trophoblastic disease: is thoracotomy justified?

From 1972 to June 1980, 138 patients were admitted into the University Gynaecological Unit, Queen Mary Hospital for persistent gestational trophoblastic tumours. Forty had pulmonary metastases, all were treated by chemotherapy and 5 died shortly after commencement of treatment. The remaining 35 patients went into biochemical remission. Five of these patients had persistent chest shadows and 2 had evidence of active disease. Thoracotomy is of doubtful value both in therapy and in predicting prognosis. These patients have an increased risk of relapse. Close and long-term follow-up HCG assay is advocated.