Effective treatment of trophoblastic tumors, choriocarcinoma, became possible with the introduction of cycle-specific chemotherapy agents some 35 years ago. This textbook is a remarkable collection of essays from first- and second-generation trophoblast centers, by the originators of this therapeutic revolution and by some of the second and third generation of physicians whom they trained. It is a significant multi-author endeavor to cover this fascinating field that combines genetic aberration and therapeutic pitfalls which require both clinical skill and experience to achieve successful outcome.
The pathologic features and the discussion of the clinical manifestation of trophoblastic disease were steeped in controversy at the end of the nineteenth century. As we enter the twenty first century, the knowledge concerning the genetic basis, the pathophysiology, the clinical categorization as well as the means of treating trophoblastic disease are much more firmly established and are all well described in this text. It is, therefore, remarkable that the diagnostic criteria and the methods of staging and assessment used in different centers as well as the way therapy is approached are still so widely divergent, and that in spite of the wealth of information opinion and practice are still so disparate. Hopefully, however, these writings will stimulate rigorous discussion that will permit consensus.
The shining spark of truth cometh forth only after the clash of differing opinions.
Paris Talks, 1909, Abdul Baha
Ernest I Kohorn MA, MChir (Cantab), FRCS, FRCOG
New Haven, Connecticut
April 2003