Gestational trophoblastic neoplasia staging

Gestational trophoblastic neoplasia Microchapters
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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]

Overview

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

Staging

The Féderation Internationale de Gynécologie et d’Obstétrique (FIGO) staging system is as follows:

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

The modified World Health Organization [WHO] prognostic scoring system is as follows:

Modified WHO Prognostic Scoring System as Adapted by FIGO
Scores	0	1	2	4
Age	<40	≥40	–	–
Antecedent pregnancy	mole	abortion	term	–
Interval months from index pregnancy	<4	4–6	7–12	>12
Pretreatment serum hCG (iu/1)	<103	103–104	104–105	>105
Largest tumor size (including uterus)	<3	3–4 cm	≥5 cm	–
Site of metastases	lung	spleen, kidney	gastrointestinal	liver, brain
Number of metastases	–	1–4	5–8	>8
Previous failed chemotherapy	–	–	single drug	≥2 drugs