Table 1.
International Federation of Gynecology and Obstetrics/World Health Organization staging and classification of gestational trophoblastic disease
| GTN: FIGO staging and classification (Washington, 2000) | ||||
| FIGO anatomic staging | ||||
| Stage I: Disease confined to the uterus | ||||
| Stage II: GTN extends outside of the uterus, but is limited to the genital structures (adnexa, vagina, broad ligament) | ||||
| Stage III: GTN extends to the lungs, with or without known genital tract involvement | ||||
| Stage IV: All other metastatic sites | ||||
| Modified WHO prognostic scoring system as adapted by FIGO | ||||
| Prognostic factors | Score | |||
| 0 | 1 | 2 | 4 | |
| Age | < 40 | ≥ 40 | - | - |
| Antecedent gestation | Mole | Abortion | Term | - |
| Interval (mo) | < 4 | 4-6 | 7-12 | > 12 |
| Pretreatment serum hCG (IU/L) | < 103 | 103 to < 104 | 104 to < 105 | > 105 |
| Largest tumor size (including uterus) | < 3 | 3 to 4 | ≥ 5 | - |
| Site of metastases | Lung | spleen, kidney | gastro intestinal tract | brain, liver |
| Number of metastases | - | 1-4 | 5-8 | > 8 |
| Previous failed chemotherapy | - | - | single drug | 2 or more drugs |
Interval (in months) between the end of antecedent gestation (when known) and symptom onset. FIGO: International Federation of Gynecology and Obstetrics; WHO: World Health Organization; GTN: Gestational trophoblastic neoplasia; hCG: Human chorionic gonadotropin.