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The doctor diagnoses a trophoblastic gestational disease (eg mole), most often on a curettage product. In the event of a question, he contacts the doctor of the Network for an opinion or immediate advice. If necessary, the doctor will tell him what to do according to the stage of the disease (monitoring of the evolution of βhCG, extension assessment to be carried out in the event of abnormal evolution, WHO classification and possible chemotherapy protocol for gestational neoplasia trophoblasts…).

With the patient's agreement, the doctor or the complete healthcare team, signs and transmits to the RMTQ the registration form, the consent to access the archives, as well as the consent to participation signed by the patient and attaches the pathology report essential for treatment. The coordinating nurse contacts the patient and sends her an information letter, ideally by email. The histological slides are then sent to one of the Network's reference pathologists who will carry out a review in order to clarify, confirm or refute the diagnosis.

Each βhCG result should be transmitted to the RMTQ if not available in the Quebec Health File (DSQ). As soon as a few consecutive dosages are obtained, the RMTQ team draws up and analyzes the βhCG evolution curve and informs the doctor who contacted them.

After the initial treatment, monitoring is centered on the dosage of βhCG. It results in regular controls of the level of plasma βhCG which will be used to establish the semi-logarithmic curve of evolution of the βhCG of the patients. These assays call for sometimes very specialized methods of βhCG assays, and require calling on a reference laboratory if necessary while continuing to have the blood samples taken by the patient's usual laboratory.

Monitoring lasts 4 to 6 months after negativation depending on the type of disease and the time to normalization (ßhCG < 5 IU/L). The doctor's and his patient's concern for information is reflected in regular exchanges of information. The updated semi-logarithmic curve of βhCG is attached to these letters.

In the event of an abnormal development, the doctor is contacted immediately by telephone so that a concerted approach can be decided. The doctor then contacts his patient himself to inform her. The patient can obviously be referred at any time to the Trophoblastic Diseases Unit (UMT) of the gynecology oncology department of the CHUM.