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Gynecol Oncol. 1993 Feb;48(2):139-47.

Evaluation of the criteria used to make the diagnosis of nonmetastatic gestational trophoblastic neoplasia.

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Department of Obstetrics & Gynecology, Yale University School of Medicine, New Haven, Connecticut 06510.


The administration of chemotherapy following hydatidiform mole evacuation implies a diagnosis of trophoblastic neoplasia. A review of the literature and an analysis of a questionnaire sent to physicians treating trophoblastic disease shows that the criteria used to make this decision vary significantly. The factors that make it important to arrive at a consensus are discussed. Alternative investigations other than hCG that may distinguish neoplasia such as doppler flow ultrasound and magnetic resonance imaging are examined critically. A definition of neoplasia is presented that relates tumor load as measured by hCG to the length of hCG plateau. The changing criteria for distinguishing metastasis are discussed.

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