Treatment and Prognosis of met Astatic Gestational Trophoblastic Disease

Three cases with metastasized choriocarcinoma are reported. The basic chemotherapeutic regimen was methotrexate and actinomycin D, combined with cyclo-phosphamide or vinblastine. Surgery was used in the treatment of both primary and metastatic lesions. The chief indications for hysterectomy arise when chemotherapy has obviously failed. Thoracotomy was performed for a pulmonary metastasis and nephrectomy for a metastasis of the kidney. Craniotomy was performed to control the brain hemorrhage. Aggressive multidrug chemotherapy is considered necessary as the primary treatment for high-risk cases of trophoblastic disease.