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Gestational Trophoblastic Disease Treatment (PDQ®)

  • Updated: 04/25/2014

Table 1. Gestational Trophoblastic Neoplasia (GTN)a,b

FIGO Anatomical Staging 
Stage
IDisease confined to the uterus.
IIGTN extends outside of the uterus, but is limited to the genital structures (adnexa, vagina, broad ligament).
IIIGTN extends to the lungs, with or without known genital tract involvement.
IVAll other metastatic sites.
Modified WHO Prognostic Scoring System as Adapted by FIGOb
Scores 0124
Age<40≥40
Antecedent pregnancymoleabortionterm
Interval months from index pregnancy<44–67–12>12
Pretreatment serum hCG (iu/1)<103103–104104–105>105
Largest tumor size (including uterus)<33–4 cm≥5 cm
Site of metastaseslungspleen, kidneygastrointestinalliver, brain
Number of metastases1–45–8>8
Previous failed chemotherapysingle drug≥2 drugs

FIGO = Féderation Internationale de Gynécologie et d’Obstétrique; hCG = human chorionic gonadotropin; iu = international unit; WHO = World Health Organization.
aAdapted from FIGO Committee on Gynecologic Oncology.[1]
bTo stage and allot a risk factor score, a patient's diagnosis is allocated to a stage as represented by a Roman numeral I, II, III, and IV. This is then separated by a colon from the sum of all the actual risk factor scores expressed in Arabic numerals, i.e., stage II:4, stage IV:9. This stage and score will be allotted for each patient.

References

  1. FIGO Committee on Gynecologic Oncology: Current FIGO staging for cancer of the vagina, fallopian tube, ovary, and gestational trophoblastic neoplasia. Int J Gynaecol Obstet 105 (1): 3-4, 2009.  [PUBMED Abstract]