Gestational trophoblastic neoplasia staging

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [2]Sabawoon Mirwais, M.B.B.S, M.D.[3]

Overview

According to the Féderation Internationale de Gynécologie et d’Obstétrique (FIGO) cancer staging system, there are 4 stages of gestational trophoblastic neoplasia (GTN).

Staging

The Féderation Internationale de Gynécologie et d’Obstétrique (FIGO) staging system ^[1]


Stage	FIGO Anatomical Staging

I	Disease confined to the uterus
II	GTN extends outside of the uterus, but is limited to the genital structures (adnexa, vagina, broad ligament)
III	GTN extends to the lungs, with or without known genital tract involvement
IV	All other metastatic sites

Modified WHO prognostic scoring system as adapted by Fédération Internationale de Gynécologie et d’Obstétrique (FIGO)^[2]

Score	0	1	3	4
Age	< 40	40	–	–
Antecedent pregnancy	Mole	Abortion	Term	–
Interval months from index pregnancy	< 4	4 – < 7	7 – < 13	≥ 13
Pre-treatment serum βhCG (iu/l)	< 10³	10³ – < 10⁴	10⁴ – < 10⁵	≥ 10⁵
Largest tumor size (including uterus)	–	3 – < 5 cm	≥ 5cm	–
Site of metastases	Lung	Spleen, Kidney	Gastrointestinal	Liver, Brain
Number of metastases	–	1 – 4	5 – 8	> 8
Previous failed chemotherapy	–	–	1 drug	2 or more drugs

References

↑ Stage Information for Gestational Trophoblastic Disease. National Cancer Institute. http://www.cancer.gov/types/gestational-trophoblastic/hp/gtd-treatment-pdq#section/_11 URL Accessed on October 7, 2015
↑ Ngan HY, Bender H, Benedet JL, Jones H, Montruccoli GC, Pecorelli S (October 2003). “Gestational trophoblastic neoplasia, FIGO 2000 staging and classification”. Int J Gynaecol Obstet. 83 Suppl 1: 175–7. PMID 14763174.

[eee-1] Stage Information for Gestational Trophoblastic Disease. National Cancer Institute. http://www.cancer.gov/types/gestational-trophoblastic/hp/gtd-treatment-pdq#section/_11 URL Accessed on October 7, 2015

[pmid14763174-2] Ngan HY, Bender H, Benedet JL, Jones H, Montruccoli GC, Pecorelli S (October 2003). “Gestational trophoblastic neoplasia, FIGO 2000 staging and classification”. Int J Gynaecol Obstet. 83 Suppl 1: 175–7. PMID 14763174.

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