Chemotherapy is not needed when complete evacuation of gestational choriocarcinoma leads to hCG normalization.

Background: The standard treatment for gestational choriocarcinoma is chemotherapy.

Objective: To describe the risk of recurrence with expectant management of gestational choriocarcinoma that has reached a normal human chorionic gonadotropin level after tumor removal without adjuvant chemotherapy.

Methods: A retrospective multicenter international cohort study was conducted from 1981 to 2017 involving 11 gestational trophoblastic disease reference centers with patient's follow-up extended until 2023.