Gestational trophoblastic disease: classification and prognostic factors (part I)

Abstract

Major research studies on the current predictors of gestational trophoblastic disease (GTD) were not conducted in Russia. The prognostic value of new prognostic factors such as the level of beta - hCG in spinal fluid in patients with disseminated tumor, the level of placental lactogen (PL) in patients with GTD have not been studied. Until now, there is no earlier criterion of tumor resistance to conventional chemotherapy (parameters beta - HCG, tumor size, etc.). As a result, clinicians often plan GTD treatment of patients according to clinical stage, apply non-standard chemotherapy regimens, which contributes to the development of tumor resistance and significantly worsens the prognosis of the disease. Thus, timely diagnosis and proper staging of GTD, it is important to optimize treatment planning. Proper treatment at an early stage can cure the vast majority of patients, using high-efficiency and low-toxicity standard first line chemotherapy regimens without harm to the reproductive health of women and reduce their quality of life. Comprehensive study of predictors of GTD will allow better planning of treatment, identify early factors tumor resistance to conventional chemotherapy and to develop evidence-based recommendations for optimizing the treatment of patients with GTD.