Patient followup and prognosis

On completion of their chemotherapy, patients are advised to avoid pregnancy for one year and remain on HCG follow-up for life to confirm that their disease is in remission. About 2% of low-risk and 4% of high-risk patients will relapse. All low-to middle-risk patients are salvaged with further chemotherapy (EMA/CO or alternative regimens) and the cure rate is almost 100% in this group. The high-risk group has 90% survival rate beyond 10 years. With the addition of platinum and other new agents salvage rates for patients relapsing following EMA/CO therapy can be in excess of 70%. Neither metho-trexate nor EMA/CO therapy reduce fertility or cause abnormalities. Thus women treated for GTD can expect to have healthy children.

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