Second Curettage in Treating Patients With Persistent Non-metastatic Gestational Trophoblastic Tumors

Inclusion Criteria:

   - Patients who have had hydatidiform mole treated by evacuation and/or curettage and now
   meet the criteria of low risk GTN, as defined by the International Federation of
   Gynecology and Obstetrics (F.I.G.O.)/World Health Organization (W.H.O.) 2002 staging
   and risk scoring criteria:

      - A plateau in the beta-hCG assay for 4 consecutive weekly levels over a period of
      3 weeks or longer; that is, days 1, 7, 14, 21; for this study, a plateau will be
      defined as less than a 10% decline using as a reference the initial value in the
      series of values taken over a period of 3 weeks; OR

      - A rise in the beta-hCG assay of 3 consecutive measurements, or longer, over at
      least a period of 2 weeks or more; days, 1, 7, 14; for this study, a rise will be
      defined as an increase of greater than 20% taking as a reference the initial
      value in the series of values taken over the 2-week period; OR

      - When the beta-hCG level remains elevated above normal for 6 months or longer

   - Patients must have a clinically significant elevated beta-hCG level of greater than 20
   mIU/ml

   - Patients must have non-metastatic low risk GTN with a W.H.O. 2002 risk score of no
   greater than 6

   - Patients must have no metastatic disease as determined by the pelvic examination,
   pelvic ultrasound, and chest x-ray

   - Patients must have signed an approved informed consent and Health Insurance
   Portability and Accountability Act (HIPAA) authorization

   - Patients must have a Gynecologic Oncology Group (GOG) performance status of 0 or 1

   - Patients must have histologically confirmed complete or partial mole

   - Patients must agree to use an accepted method of contraception (oral contraceptives,
   birth control patches, Depo-Provera, diaphragm, contraceptive foam and condom, or
   male/female sterilization)

   - Patients must meet pre-entry requirements

Exclusion Criteria:

   - Patients who do not have persistent low-risk GTN

   - Patients with any evidence of metastatic disease beyond the uterus

   - Patients with persistent or recurrent GTN (same gestation) that have already been
   treated with chemotherapy

   - Patients with other invasive malignancies, with the exception of non-melanoma skin
   cancer, patients who have had any evidence of the other cancer present within the last
   5 years or patients whose previous cancer treatment contraindicates this protocol
   therapy

   - Patients with histologically confirmed choriocarcinoma, placental site trophoblastic
   tumor (PSTT) or epithelioid trophoblastic tumor (ETT) on the first curettage

   - Patients who refuse to use an accepted method of contraception

   - Patients who have had more than one curettage for the management of the current
   disease or who have undergone hysterectomy