BACKGROUND AND AIM Gestational trophoblastic disease (GTD) is a heterogeneous group of disorders characterised by abnormal proliferation of trophoblastic tissue. Since GTD and its malignant sequel gestational trophoblastic neoplasia (GTN) are rare diseases, little evidence is available from randomised controlled trials on optimal treatment and follow-up. Treatment protocols vary within Europe, and even between different centres within countries. One of the goals of the 'European Organisation for Treatment of Trophoblastic Diseases' (EOTTD) is to harmonise treatment in Europe. To provide a basis for European standardisation of definitions, treatment and follow-up protocols in GTD, we composed a set of guidelines for minimal requirements and optimal management of GTD. METHODS Members from each EOTTD country attended multiple workshops during annual EOTTD meetings. Clinical guidelines were formulated by consensus and evidence where available. The following guidelines were discussed: diagnostics of GTD and GTN, treatment of low-risk GTN, high-risk GTN, ultra-high-risk GTN, placental site and epithelioid trophoblastic tumours and follow-up. RESULTS Between 40 and 65 EOTTD members from 17 European countries and 7 non-European countries attended the clinical workshops held on 6 occasions. Flow diagrams for patient management were composed to display minimum and best practice for most treatment situations. New agreed definitions of recurrence and chemotherapy resistance were formulated. CONCLUSIONS Despite the many differences between and within the participating countries, an important step in uniform treatment of GTD and GTN within Europe was made by the Clinical Working Party of the EOTTD. This is an example on how guidelines and harmonisation can be achieved within international networks.

中文翻译：

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EOTTD治疗和转诊滋养细胞疾病的实用临床指南。

背景与目的妊娠滋养细胞疾病（GTD）是一组异种疾病，其特征在于滋养细胞组织异常增生。由于GTD及其恶性后遗妊娠滋养细胞肿瘤（GTN）是罕见病，因此关于最佳治疗和随访的随机对照试验几乎没有证据。在欧洲，甚至在国家内部的不同中心之间，治疗方案也有所不同。“欧洲滋养细胞疾病治疗组织”（EOTTD）的目标之一是协调欧洲的治疗。为了为GTD中的定义，治疗和后续方案的欧洲标准化提供基础，我们制定了一套指导方针，以实现对GTD的最低要求和最佳管理。方法来自每个EOTTD国家的成员在EOTTD年度会议期间参加了多个研讨会。临床指南由共识和证据（如有）制定。讨论了以下指南：GTD和GTN的诊断，低危GTN，高危GTN，超高危GTN，胎盘部位和上皮样滋养细胞肿瘤的治疗和随访。结果来自17个欧洲国家和7个非欧洲国家的40至65位EOTTD成员参加了6次临床研讨会。制定了患者管理流程图，以显示大多数治疗情况的最小和最佳实践。制定了新的公认的复发和化疗耐药性定义。结论尽管参与国之间和内部存在许多差异，EOTTD临床工作组在欧洲范围内对GTD和GTN进行统一治疗的重要一步。这是关于如何在国际网络中实现准则和统一的一个例子。