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What is Indications for instituting single-agent chemotherapy following evacuation of a hydatidiform mole usually include and explain in detail?
(Mishell, 3/e, pp 455-456.) Single-agent chemotherapy is usually instituted if levels of hCG remain elevated 8 weeks after evacuation of a hydatidiform mole. Approximately 50% of the patients who have persistently high hCG titers will develop malignant sequelae. If hCG titers rise or reach a plateau for 2 to 3 successive weeks following molar evacuation, a single-agent chemotherapy should be instituted, provided that the trophoblastic disease has not metastasized to the liver or brain. The presence of such metastases usually requires initiation of combination chemotherapy.