Second Curettage for Low-Risk Nonmetastatic Gestational Trophoblastic Neoplasia
September 1, 2016
A second uterine curettage is safe and effective to treat women with low-risk non-metastatic GTN in lieu of chemotherapy
pelvic US, CXR/CT chest, hcguterine curretagefollow w/hcg
Surgical cure
complete or partial mole treated w/initial D&Cnow diagnosed w/GTNWHO score: 0-6
prior chemotherapydisease outside of uterushcg <20
n=6090% complete molemedian f/u: 24 mossurgical cure rate: 40%1 pt w/perforation1 pt w/grade 3 hemorrhage
Second curettage cures 40% of women with low-risk non-metastatic GTN, with minimal morbidity