NCCN Issues Guidelines for Management of Rare Gestational Cancers

Jason Harris
Published: Thursday, Oct 18, 2018
Nadeem R. Abu-Rustum, MD

Nadeem R. Abu-Rustum, MD

The National Comprehensive Cancer Network (NCCN) has issued the first-ever guidelines for the treatment of women with gestational trophoblastic neoplasia (GTN), a rare set of tumors that develop from placental cells. The guidelines recommend single-agent chemotherapy for most patients with low-risk disease; surgery and combination chemotherapy are advised for patients with high-risk GTN.1

. “We can use that to decide which patients need treatment based on the fall to normal [hCG levels] or persistent disease.

Figure. NCCN Guidelines for Treatment of Gestational Trophoblastic Neoplasia

Figure. NCCN Guidelines for Treatment of Gestational Trophoblastic Neoplasia
He added that these guidelines are also meant to be educational. Because GTN is rare, few oncologists, even gynecologic oncologists, are familiar with the disease. According to the ACS, almost all women with complete or partial moles and low-risk GTN can be cured, and cure rates are high for placental-site trophoblastic tumors. The prognosis is not as good if the disease metastasizes beyond the uterus, but even for high-risk GTD, cure rates range from 80% to 90%.
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