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

PRIMARY OBJECTIVES: I. To determine the response to second curettage in patients with persistent, non-metastatic gestational trophoblastic neoplasia (GTN). SECONDARY OBJECTIVES: I. To evaluate if response to a second curettage is independent of the tumor burden as measured by the quantitative beta-human chorionic gonadotropin (hCG) assay at study entry. II. To evaluate if response to a second curettage is independent of the depth of myometrial invasion as measured sonographically following the initial curettage but prior to study entry (when persistent disease is first diagnosed). III. To estimate the frequency of complications related to a second curettage, specifically infection of the fallopian tubes or ovaries, hemorrhage associated with curettage, or operative injury to the uterus. IV. To estimate the frequency of a change in the uterine histology between the first and second curettage. OUTLINE: Patients undergo a second curettage rather than standard treatment (immediate chemotherapy) within 14 days of registration. After completion of study treatment, patients are followed up at 14 days, weekly for 4 weeks, and then monthly for 5 months, and then every 3 months for 24 months.