Objectives
  • To be able to describe the different types of gestational trophoblastic neoplasia (GTN) (including complete and partial molar pregnancy, invasive mole, choriocarcinoma and placental site trophoblastic tumours), including molecular pathogenesis

  • To be able to perform specialist assessment, staging, treatment and counselling of patients with GTN

  • To be able to counsel and treat patients with recurrent or persistent disease

Awareness
  • Awareness of staging systems, including International Federation of Gynecology and Obstetrics (FIGO) anatomical staging for GTN and modified WHO prognostic scoring system

  • Awareness of chemotherapy options for early- and late-stage disease as well as persistent/recurrent disease

  • Recognition of the role of surgery in disease management

  • Awareness of surveillance following treatment (including prevention of pregnancy during surveillance period)

  • Appreciation of the management of subsequent pregnancies

Knowledge
  • Familiarity with staging according to FIGO and with providing prognostic information (WHO) for GTN

  • Familiarity with the different histological types of GTN and their prognosis

  • Familiarity with the diagnostic evaluation of GTN, including the role and limitations of computed tomography (CT), magnetic resonance imaging (MRI) and pelvic ultrasound

  • Understanding of the role of primary surgery in the management of complete and partial molar pregnancies

  • Understanding of the management of GTN by FIGO stage, including the indications for single-agent versus multiple-agent chemotherapy, and the role of chemotherapy in the treatment of persistent or recurrent disease

  • Understanding of the surveillance of GTN following treatment, including the importance of (and methods for) preventing subsequent pregnancy

Skills
  • Ability to contribute to discussions on general management strategies for the management of suspected molar pregnancy

  • Ability to contribute to discussions on treatment of GTN (all stages), including management of placental site trophoblastic tumour

  • Ability to prescribe single-agent versus combination chemotherapy and to discuss the benefits and limitations of different chemotherapy options

  • Ability to discuss with patients the surveillance strategy, including the prevention of subsequent pregnancy during the surveillance period and the risk of recurrent disease in a subsequent pregnancy