Information for Clinicians

Charing Cross Hospital (CXH) Trophoblast Disease Clinic Guide


GTT Scientific and Clinical Publications

The GTT unit at Charing Cross Hospital has been closely involved in developing the treatment of GTT. We have listed below the most recent publications along with their PubMed links. Also lower down the page are some of the key historical publications from Charing Cross that have helped develop the current successful management of GTT.

Historical Interest

Bagshawe KD Risk and prognostic factors in trophoblastic neoplasia Cancer. 1976 Sep;38(3):1373-85

Bagshawe KD, Dent J, Webb J Hydatidiform mole in England and Wales 1973-83 Lancet. 1986 Sep 20;2(8508):673-7


Paradinas FJ The diagnosis and prognosis of molar pregnancy: the experience of the National Referral Centre in London Int J Gynaecol Obstet. 1998 Apr;60 Suppl 1:S57-64


Sebire NJ, Foskett M, Fisher RA, Rees H, Seckl M, Newlands E. Risk of partial and complete hydatidiform molar pregnancy in relation to maternal age BJOG. 2002 Jan;109(1):99-102

Sebire NJ, Fisher RA, Foskett M, Rees H, Seckl MJ, Newlands ES. Risk of recurrent hydatidiform mole and subsequent pregnancy outcome following complete or partial hydatidiform molar pregnancy. BJOG. 2003 Jan;110(1):22-6

Sebire NJ, Foskett M, Paradinas FJ, Fisher RA, Francis RJ, Short D, Newlands ES, Seckl MJ. Outcome of twin pregnancies with complete hydatidiform mole and healthy co-twin. Lancet. 2002 Jun 22;359(9324):2165-6

Low Risk Disease

Bagshawe KD, Dent J, Newlands ES, Begent RH, Rustin GJ. The role of low-dose methotrexate and folinic acid in gestational trophoblastic tumours (GTT) Br J Obstet Gynaecol. 1989 Jul;96(7):795-802

McNeish IA, Strickland S, Holden L, Rustin GJ, Foskett M, Seckl MJ, Newlands ES Low-risk persistent gestational trophoblastic disease: outcome after initial treatment with low-dose methotrexate and folinic acid from 1992 to 2000. J Clin Oncol. 2002 Apr 1;20(7):1838-44

Savage P, Seckl MJ. The role of repeat uterine evacuation in trophoblast disease. Gynecol Oncol. 2005 Oct;99(1):251-2

High Risk Disease

Newlands ES, Bagshawe KD, Begent RH, Rustin GJ, Holden L Results with the EMA/CO (etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine) regimen in high risk gestational trophoblastic tumours, 1979 to 1989. Br J Obstet Gynaecol. 1991 Jun;98(6):550-7

Bower M, Newlands ES, Holden L, Short D, Brock C, Rustin GJ, Begent RH, Bagshawe KD EMA/CO for high-risk gestational trophoblastic tumors: results from a cohort of 272 patients J Clin Oncol. 1997 Jul;15(7):2636-43

CNS Metastases

Newlands ES, Holden L, Seckl MJ, McNeish I, Strickland S, Rustin GJ. Management of brain metastases in patients with high-risk gestational trophoblastic tumors J Reprod Med. 2002 Jun;47(6):465-71


Newlands ES, Mulholland PJ, Holden L, Seckl MJ, Rustin GJ Etoposide and cisplatin/etoposide, methotrexate, and actinomycin D (EMA) chemotherapy for patients with high-risk gestational trophoblastic tumors refractory to EMA/cyclophosphamide and vincristine chemotherapy and patients presenting with metastatic placental site trophoblastic tumors J Clin Oncol. 2000 Feb;18(4):854-9

Papadopoulos AJ, Foskett M, Seckl MJ, McNeish I, Paradinas FJ, Rees H, Newlands ES Twenty-five years' clinical experience with placental site trophoblastic tumors J Reprod Med. 2002 Jun;47(6):460-4

Genetics of GTT

Fisher RA, Newlands ES Jeffreys AJ et al (1992). Gestational and non-gestational trophoblastic tumours distinguished by DNA analysis. British Journal of Cancer 69: 839-845

Paradinas FJ & Fisher RA (1995). Pathology and molecular genetics of trophoblastic disease. Current Obstetrics & Gynaecology (1995) 5, 6-12

Fisher RA, Khatoon R, Paradinas FJ, Roberts AP, Newlands ES. Repetitive complete hydatidiform mole can be biparental in origin and either male or female. Hum Reprod. 2000 Mar;15(3):594-8

Imaging in GTT

Fowler DJ, Lindsay I, Seckl MJ, Sebire NJ. Routine pre-evacuation ultrasound diagnosis of hydatidiform mole: experience of more than 1000 cases from a regional referral center. Ultrasound Obstet Gynecol. 2006 Jan;27(1):56-60

Lim AK, Agarwal R, Seckl MJ, Newlands ES, Barrett NK, Mitchell AW. Embolization of bleeding residual uterine vascular malformations in patients with treated gestational trophoblastic tumors. Radiology. 2002 Mar;222(3):640-4

Long Term Follow-Up

Bower M, Rustin GJ, Newlands ES, Holden L, Short D, Foskett M, Bagshawe KD Chemotherapy for gestational trophoblastic tumours hastens menopause by 3 years Eur J Cancer. 1998 Jul;34(8):1204-7

Rustin GJ, Newlands ES, Lutz JM, Holden L, Bagshawe KD, Hiscox JG, Foskett M, Fuller S, Short D Combination but not single-agent methotrexate chemotherapy for gestational trophoblastic tumors increases the incidence of second tumors J Clin Oncol. 1996 Oct;14(10):2769-73

Wenzel L, Berkowitz RS, Newlands E, Hancock B, Goldstein DP, Seckl MJ, Habbal R, Bernstein M, Kluhsman B, Kulchak-Rahm A, Strickland S, Higgins J Quality of life after gestational trophoblastic disease J Reprod Med. 2002 May;47(5):387-94.

Blagden SP, Foskett MA, Fisher RA, Short D, Fuller S, Newlands ES, Seckl MJ. The effect of early pregnancy following chemotherapy on disease relapse and foetal outcome in women treated for gestational trophoblastic tumours. Br J Cancer. 2002 Jan 7;86(1):26-30

Woolas RP, Bower M, Newlands ES, Seckl M, Short D, Holden LWoolas RP, Bower M, Newlands ES, Seckl M, Short D, Holden L. Influence of chemotherapy for gestational trophoblastic disease on subsequent pregnancy outcome. Br J Obstet Gynaecol. 1998 Sep;105(9):1032-5

Recent Publications

Fowler DJ, Lindsay I, Seckl MJ, Sebire NJ. Histomorphometric features of hydatidiform moles in early pregnancy: relationship to detectability by ultrasound examination. Ultrasound Obstet Gynecol. 2007 Jan;29(1):76-80.

Dhillon T, Palmieri C, Sebire NJ, Lindsay I, Newlands ES, Schmid P, Savage PM, Frank J, Seckl MJ. Value of whole body 18FDG-PET to identify the active site of gestational trophoblastic neoplasia. J Reprod Med. 2006 Nov;51(11):879-87

Powles T, Young A, Sanitt A, Stebbing J, Short D, Bower M, Savage PM, Seckl MJ, Schmid P The significance of the time interval between antecedent pregnancy and diagnosis of high-risk gestational trophoblastic tumours Br J Cancer. 2006 Dec 18;95(12):1709

Powles T, Young A, Sanitt A, Stebbing J, Short D, Bower M, Savage PM, Seckl MJ, Schmid P. The significance of the time interval between antecedent pregnancy and diagnosis of high-risk gestational trophoblastic tumours. Br J Cancer. 2006 Nov 6;95(9):1145-7.

Burke B, Sebire NJ, Moss J, Hodges MD, Seckl MJ, Newlands ES, Fisher RA. Evaluation of deletions in 7q11.2 and 8p12-p21 as prognostic indicators of tumour development following molar pregnancy. Gynecol Oncol. 2006 Nov;103(2):642-8

Dhillo WS, Savage P, Murphy KG, Chaudhri OB, Patterson M, Nijher GM, Foggo VM, Dancey GS, Mitchell H, Seckl MJ, Ghatei MA, Bloom SR. Plasma kisspeptin is raised in patients with gestational trophoblastic neoplasia and falls during treatment.Am J Physiol Endocrinol Metab. 2006 Nov;291(5)878-84

Khan S, Dancey G, Lindsay I, Sebire NJ, Fisher RA, Seckl MJ, Savage P. Placental site trophoblastic tumour derived from an oocyte donation pregnancy. BJOG. 2006 Mar;113(3):344-6

Powles T, Savage P, Short D, Young A, Pappin C, Seckl MJ. Residual lung lesions after completion of chemotherapy for gestational trophoblastic neoplasia: should we operate? Br J Cancer. 2006 Jan 16;94(1):51-4

El-Helw LM, Seckl MJ, Haynes R, Evans LS, Lorigan PC, Long J, Kanfer EJ, Newlands ES, Hancock BW. High-dose chemotherapy and peripheral blood stem cell support in refractory gestational trophoblastic neoplasia. Br J Cancer. 2005 Sep 19;93(6):620-1

Sebire NJ, Lindsay I, Fisher RA, Seckl MJ. Intraplacental choriocarcinoma: experience from a tertiary referral center and relationship with infantile choriocarcinoma. Fetal Pediatr Pathol. 2005 Jan-Feb;24(1):21-9

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