Soper J T
Division of Gynecologic Oncology, Duke University Medical Center.
Oncology (Williston Park). 1993 Nov;7(11):68-74, 82; discussion 83-4, 86, 91.
Gestational trophoblastic disease (GTD) embraces a spectrum of neoplasms of the placenta. Hydatidiform moles are managed by molar evacuation and expectant surveillance of quantitative serum hCG levels. Approximately 80% of complete moles and more than 90% to 95% of partial moles will enter complete remission without further therapy. Malignant GTD can occur after any type of pregnancy. The prognosis is determined by several clinical risk factors, including anatomic site(s) of disease, duration of disease, hCG level, and type of antecedent pregnancy. Patients with nonmetastatic and low-risk metastatic GTD have an excellent outcome when treated with single-agent chemotherapy. Even patients with high-risk disease may have survival rates of approximately 80%, but only if patients in this category are treated with initial aggressive multiagent chemotherapy. Combined modality therapy is often required to optimize outcome in high-risk patients. Most women with malignant GTD can be cured and retain reproductive function.
妊娠滋养细胞疾病（GTD）涵盖了一系列胎盘肿瘤。葡萄胎通过清宫术及对血清hCG定量水平进行随访监测来处理。约80%的完全性葡萄胎和90%至95%以上的部分性葡萄胎无需进一步治疗即可完全缓解。任何类型的妊娠后都可能发生恶性GTD。预后由多种临床风险因素决定，包括疾病的解剖部位、病程、hCG水平及前次妊娠类型。非转移性和低风险转移性GTD患者采用单药化疗治疗效果良好。即使是高危疾病患者，生存率也可能约为80%，但前提是此类患者接受初始积极的多药联合化疗。高危患者通常需要联合治疗以优化治疗效果。大多数恶性GTD女性患者可治愈并保留生殖功能。
