Gestational trophoblastic neoplasia diagnostic study of choice
|
Gestational trophoblastic neoplasia Microchapters |
|
Differentiating Gestational trophoblastic neoplasia from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Gestational trophoblastic neoplasia diagnostic study of choice On the Web |
|
American Roentgen Ray Society Images of Gestational trophoblastic neoplasia diagnostic study of choice |
|
FDA on Gestational trophoblastic neoplasia diagnostic study of choice |
|
CDC on Gestational trophoblastic neoplasia diagnostic study of choice |
|
Gestational trophoblastic neoplasia diagnostic study of choice in the news |
|
Blogs on Gestational trophoblastic neoplasia diagnostic study of choice |
|
Directions to Hospitals Treating Gestational trophoblastic neoplasia |
|
Risk calculators and risk factors for Gestational trophoblastic neoplasia diagnostic study of choice |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2]
Overview
Ultrasound is the diagnostic study of choice for gestational trophoblastic neoplasia. Anomalous rise in the level of serum beta hCG can also serve as an adjunct investigation to rule in gestational trophoblastic neoplasia.
Diagnostic Study of Choice
Study of Choice
Ultrasound is the diagnostic study of choice for gestational trophoblastic neoplasia. It is usually the first test done if gestational trophoblastic tumour is suspected.[1]
- It is used to:
- Identify most types of gestational trophoblastic disease
- Check for metastasis in the pelvis or abdomen
- Plan treatment
Staging
The Féderation Internationale de Gynécologie et d’Obstétrique (FIGO) staging system [2]
| Stage | FIGO Anatomical Staging |
|---|---|
|
I |
|
|
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)[3]
| 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
- ↑ Diagnosing gestational trophoblastic disease. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/gestational-trophoblastic-disease/diagnosis/?region=ns Accessed on October 12, 2015
- ↑ 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.