Pretreatment Curettage—A Predictor of Chemotherapy Response in Gestational Trophoblastic Neoplasia

Abstract Thirty-seven patients, who developed trophoblastic proliferation following molar evacuation, underwent endometrial curettage as part of their pretreatment evaluation to assess the pathology of pretreatment curettings as a predictor of response to chemotherapy. Twenty patients had no trophoblastic tissue obtained at the pretreatment curettage and nineteen of these patients achieved complete sustained remission with only one course of chemotherapy. Seven patients had worsened trophoblastic histology in their pretreatment curettings and six of these patients (86%) required multiple courses of chemotherapy to attain complete remission. The seven patients with worsened trophoblastic histology may represent part of the spectrum of trophoblastic neoplasia with a more virulent natural history. Pathologic analysis of trophoblastic tissue provided prognostically important data regarding potential responsiveness to chemotherapy.