Which of the following is the treatment of choice for choriocarcinoma in a middle-aged woman?

The treatment of choice for choriocarcinoma is chemotherapy. This is because it is not a local tumour but are systemic disease which is sensitive to chemotherapy. Hysterectomy used to be used in the past but frequently resulted in metastasis. Combined chemotherapy EMA (Etoposide, MTX and and Actinomycin D) or futher combination with CO (cyclophosphamide and vincristine) is effective. Ref: Donald School Textbook of Ultrasound in Obstetrics & Gynecology, 3rd Edition, Asim Kurjak, Fran A. Chervenak, Page 169.