Chemotherapy after molar pregnancy

The use of chemotherapy after molar pregnancy does not necessary mean there has been a malignant transformation. About one in five (20%) patients with molar pregnancy will need chemotherapy.

The majority of patients requiring chemotherapy will have what is known as a persistent mole. ‘Persistent mole’ is a warning sign that malignant transformation may follow. Chemotherapy is therefore a pre-emptive measure.

Less than 25% of those receiving chemotherapy do so because of a malignant transformation.

Understanding choriocarcinoma

Choriocarcinoma is an aggressive tumour, which is associated with pregnancy in the overwhelming majority of those affected.

The pregnancy that precedes a choriocarcinoma could be molar, normal, ectopic or even a miscarriage.

The majority (over 5O%) of choriocarcinoma follow a molar pregnancy, about a quarter follow normal pregnancy, and a smaller proportion follow miscarriage or ectopic pregnancies.

Choriocarcinoma is fortunately very sensitive to chemotherapy and the cure rate approaches 100 per cent, especially when it is caught in the early stages.

Time-line of choriocarcinoma

In most cases, choriocarcinoma will be discovered within days or weeks of the preceding pregnancy.

However, in some cases, it may occur several months - even years - after the initial pregnancy, which may make suspicion and therefore diagnosis quite difficult.

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Even with brain metastasis, choriocarcinoma can be successfully cured with chemotherapy