Chemotherapy combined with surgery in the treatment of gestational trophoblastic disease (GTD).

Surgery combined with chemotherapy was applied in 34 out of 178 patients (19.1%) with GTD during treatment at the Institute of Oncology in Warsaw in the years 1977-1989. This mode of treatment was used twice as often in patients with MTD (Metastatic Tumour Disease) (31.6%) than in those with NMTD (Non Metastatic Tumour Disease) (14.2%). All 34 patients, who were operated on, had hysterectomy and 3 of them thoracotomy also. The most common indication for surgery was the chemoresistance of the disease, which had been stated in 53% of all treated surgically. All the patients with NMTD and those with good prognosis MTD, treated by combination of chemotherapy and surgery were cured, which confirms the efficacy of adjuvant surgery in these groups of patients. The role of surgery in patients with high-risk MTD is limited because of disseminated disease, frequently seen in this group.