WHO Scoring System in Metastatic Gestational Trophoblastic Disease*
Prognostic Factor | Description | Score† |
|---|---|---|
Age (years) | < 40 | 0 |
≥ 40 | 1 | |
Preceding pregnancy | Mole | 0 |
Abortion | 1 | |
Term | 2 | |
Interval (months)‡ | < 4 | 0 |
4–6 | 1 | |
7–12 | 2 | |
> 12 | 4 | |
Pretreatment serum hCG (IU/mL) | < 1000 | 0 |
1,000−< 10,000 | 1 | |
10,000−< 100,000 | 2 | |
≥ 100,000 | 4 | |
Largest tumor, including any uterine tumors | 3−< 5 cm | 1 |
≥ 5 cm | 2 | |
Site of metastases | Lungs | 0 |
Spleen, kidneys | 1 | |
Gastrointestinal tract | 2 | |
Brain, liver | 4 | |
Number of metastases identified | 1−4 | 1 |
5−8 | 2 | |
> 8 | 4 | |
Number of chemotherapy agents used unsuccessfully | 1 | 2 |
≥ 2 | 4 | |
* Does not apply to placental site trophoblastic disease or epithelioid trophoblastic tumor. | ||
† Total score obtained by adding the score for each prognostic factor:
| ||
‡ Between the end of the preceding pregnancy and the start of chemotherapy. | ||
hCG = human chorionic gonadotropin.human chorionic gonadotropin. | ||
Adapted from AJCC Cancer Staging Manual, ed. 8. New York, Springer, 2017. | ||