Sixty patients who developed persistent or metastatic gestational trophoblastic disease (GTD) received primary oral etoposide therapy (VP 16-213). Twelve patients had metastatic GTD. Fifty-nine patients achieved biochemical remission. One patient had marked nausea and vomiting and the therapy was switched to a methotrexate/folinic acid regimen. Three patients developed relapse of GTD, giving a relapse rate of 5.1%. Etoposide is an active drug against choriocarcinoma. Its use should not be restricted to drug-resistant GTD.

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Neoplasm in the vagina which occurs following treatment of cervical carcinoma could represent a separate primary neoplasm, a "field" response to a common carcinogen, or be due to neoplastic transformation of tissue from previous radiation treatment. Fifty patients with a second neoplasm in the vagina were identified: 17 following total hysterectomy for carcinoma in situ of cervix; 4 following radical hysterectomy; and 29 following radiotherapy for invasive cervical carcinoma. Their clinical features, diagnosis, and treatment modalities are presented. Since vaginal neoplasm may occur long after treatment of the initial cervical carcinoma especially after previous radiotherapy, lifelong follow-up of all patients with cervical carcinoma is mandatory.

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