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In addition to histology, molecular genetic studies can help in the diagnostic pathway. Earlier detection of molar pregnancy by ultrasound has resulted in changes in clinical presentation and decreased morbidity from uterine evacuation. Follow\u2010up with human chorionic gonadotropin (hCG) is essential for early diagnosis of gestational trophoblastic neoplasia (GTN). The duration of hCG monitoring varies depending on histological type and regression rate. Low\u2010risk GTN (International Federation of Gynecology and Obstetrics [FIGO] Stages I\u2013III: score &lt;7) is treated with single\u2010agent chemotherapy but may require additional agents. Although scores of 5\u20136 are associated with higher drug resistance, overall survival approaches 100%. High\u2010risk GTN (FIGO Stages II\u2013III: score \u22657 and Stage IV) is treated with multi\u2010agent chemotherapy, with or without adjuvant surgery for excision of resistant foci of disease or radiotherapy for brain metastases, achieving a survival rate of approximately 90%. Gentle induction chemotherapy in ultra\u2013high\u2010risk disease helps reduce early deaths in patients with extensive tumor burden, but late mortality still occurs from recurrent treatment\u2010resistant tumors. Immunotherapy can be considered in recurrence.<\/jats:p>","DOI":"10.1002\/ijgo.70275","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T13:55:39Z","timestamp":1752069339000},"page":"78-86","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":65,"title":["Diagnosis and management of gestational trophoblastic disease: 2025 update"],"prefix":"10.1002","volume":"171","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3945-159X","authenticated-orcid":false,"given":"Hextan Y. 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