Version July 2025
Nonmetastatic PSTT or ETT is defined as FIGO stage I GTN (refer to inset).
All patients are followed with weekly hCG levels until normal (<5 mIU/mL) for three weeks and then monthly until 12 months of normal hCG levels have been documented.PSTT: placental site trophoblastic tumor; ETT: epithelioid trophoblastic tumor; FIGO: International Federation of Gynecology and Obstetrics; GTN: gestational trophoblastic neoplasia; ActD: dactinomycin; hCG: human chorionic gonadotropin.
* Case reports indicate that local resection may be successful in carefully selected patients who wish to preserve fertility; however, hysterectomy remains the optimal treatment in most cases.
¶ Given the high risk of recurrence and poor survival for such patients, chemotherapy is typically with etoposide plus cisplatin with etoposide, methotrexate, plus ActD ("EP/EMA") followed by pembrolizumab.