Table 3.

Treatment protocols for stage I gestational trophoblastic neoplasia (New England Trophoblastic Disease Center).

Initial	Sequential MTX/ACT-D
	Hysterectomy (with adjunctive single-agent chemotherapy)
Resistant to both single-agents	MAC
	EMACO, if MAC fails
	Hysterectomy (with adjunctive multiagent chemotherapy)
	Local uterine resection (for localized lesion, to preserve, fertility)
Followup	12 consecutive months of normal hCG levels
	Contraception mandatory

ACT-D: actinomycin D; EMACO: etoposide, methotrexate, actinomycin D, cytoxan, oncovin; MAC: methotrexate, actinomycin D, cytoxan; MTX: methotrexate.