Gestational trophoblastic neoplasia staging: Difference between revisions
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{{ | {{Gestational trophoblastic neoplasia}} | ||
__NOTOC__ | __NOTOC__ | ||
{{CMG}}{{AE}}{{MD}} | |||
{{CMG}}{{AE}}{{MD}}{{Sab}} | |||
==Overview== | ==Overview== | ||
According to the FIGO [[cancer staging]] system, there are 4 stages of | According to the Féderation Internationale de Gynécologie et d’Obstétrique (FIGO) [[cancer staging]] system, there are 4 stages of gestational trophoblastic neoplasia (GTN). | ||
==Staging== | ==Staging== | ||
{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align=center | '''The Féderation Internationale de Gynécologie et d’Obstétrique (FIGO) staging system''' <ref name="eee">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</ref> | ||
|valign=top| | {| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align="center" | ||
| valign="top" | | |||
|+ | |+ | ||
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Stage}} | ! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Stage}} | ||
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I | I | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
Disease confined to the uterus | [[Disease]] confined to the [[uterus]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
II | II | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
GTN extends outside of the uterus, but is limited to the genital structures (adnexa, vagina, broad ligament) | GTN extends outside of the [[uterus]], but is limited to the genital structures ([[adnexa]], [[vagina]], [[Broad ligament of the uterus|broad ligament]]) | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
III | III | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
GTN extends to the lungs, with or without known genital tract involvement | GTN extends to the [[Lung|lungs]], with or without known [[Urinary system|genital tract]] involvement | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
IV | IV | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
All other metastatic sites | All other [[Metastasis|metastatic]] sites | ||
|} | |} | ||
'''Modified WHO prognostic scoring system as adapted by Fédération Internationale de Gynécologie et d'Obstétrique (FIGO)'''<ref name="pmid14763174">{{cite journal |vauthors=Ngan HY, Bender H, Benedet JL, Jones H, Montruccoli GC, Pecorelli S |title=Gestational trophoblastic neoplasia, FIGO 2000 staging and classification |journal=Int J Gynaecol Obstet |volume=83 Suppl 1 |issue= |pages=175–7 |date=October 2003 |pmid=14763174 |doi= |url=}}</ref> | |||
{| {{table}} cellpadding="4" cellspacing="0" style="border:#c9c9c9 1px solid; margin: 1em 1em 1em 0; border-collapse: collapse;" | |||
{| {{table}} | ! style="background: #4479BA;" | {{fontcolor|#FFF|'''Score'''}} | ||
! style="background: #4479BA;" | {{fontcolor|#FFF|'''0'''}} | |||
| | ! style="background: #4479BA;" | {{fontcolor|#FFF|'''1'''}} | ||
| | ! style="background: #4479BA;" | {{fontcolor|#FFF|'''3'''}} | ||
! style="background: #4479BA;" | {{fontcolor|#FFF|'''4'''}} | |||
|- | |- | ||
| Age||<40|| | | style="padding: 5px 5px; background: #DCDCDC; " | Age|| style="padding: 5px 5px; background: #F5F5F5;" |< 40|| style="padding: 5px 5px; background: #F5F5F5;" |40|| style="padding: 5px 5px; background: #F5F5F5;" |-|| style="padding: 5px 5px; background: #F5F5F5;" |- | ||
|- | |- | ||
| Antecedent pregnancy||mole|| | | style="padding: 5px 5px; background: #DCDCDC; " |Antecedent [[pregnancy]]|| style="padding: 5px 5px; background: #F5F5F5;" |[[Hydatidiform mole|Mole]]|| style="padding: 5px 5px; background: #F5F5F5;" |Abortion|| style="padding: 5px 5px; background: #F5F5F5;" |Term|| style="padding: 5px 5px; background: #F5F5F5;" |- | ||
|- | |- | ||
| Interval months from index pregnancy||<4|| | | style="padding: 5px 5px; background: #DCDCDC; " | Interval months from index [[pregnancy]]|| style="padding: 5px 5px; background: #F5F5F5;" |< 4|| style="padding: 5px 5px; background: #F5F5F5;" |4 - < 7|| style="padding: 5px 5px; background: #F5F5F5;" |7 - < 13|| style="padding: 5px 5px; background: #F5F5F5;" |≥ 13 | ||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" | Pre-treatment [[serum]] [[Human chorionic gonadotropin|βhCG]] | ||
(iu/l) | |||
| style="padding: 5px 5px; background: #F5F5F5;" |< 10<sup>3</sup> || style="padding: 5px 5px; background: #F5F5F5;" |10<sup>3</sup> - < 10<sup>4</sup>|| style="padding: 5px 5px; background: #F5F5F5;" |10<sup>4</sup> - < 10<sup>5</sup>|| style="padding: 5px 5px; background: #F5F5F5;" |≥ 10<sup>5</sup> | |||
|- | |- | ||
| Largest tumor size (including uterus)||< | | style="padding: 5px 5px; background: #DCDCDC;" | Largest [[tumor]] size (including [[uterus]])|| style="padding: 5px 5px; background: #F5F5F5;" |- || style="padding: 5px 5px; background: #F5F5F5;" |3 - < 5 cm|| style="padding: 5px 5px; background: #F5F5F5;" |≥ 5cm|| style="padding: 5px 5px; background: #F5F5F5;" |- | ||
|- | |- | ||
| Site of metastases|| | | style="padding: 5px 5px; background: #DCDCDC; " | Site of [[Metastasis|metastases]]|| style="padding: 5px 5px; background: #F5F5F5;" |[[Lung]]|| style="padding: 5px 5px; background: #F5F5F5;" |[[Spleen]], [[Kidney]]|| style="padding: 5px 5px; background: #F5F5F5;" |[[Gastrointestinal tract|Gastrointestinal]]|| style="padding: 5px 5px; background: #F5F5F5;" |[[Liver]], [[Brain]] | ||
|- | |- | ||
| Number of metastases|| | | style="padding: 5px 5px; background: #DCDCDC;" | Number of [[Metastasis|metastases]]|| style="padding: 5px 5px; background: #F5F5F5;" |- || style="padding: 5px 5px; background: #F5F5F5;" |1 - 4|| style="padding: 5px 5px; background: #F5F5F5;" |5 - 8|| style="padding: 5px 5px; background: #F5F5F5;" |> 8 | ||
|- | |- | ||
| Previous failed chemotherapy|| | | style="padding: 5px 5px; background: #DCDCDC;" |Previous failed [[chemotherapy]]|| style="padding: 5px 5px; background: #F5F5F5;" |- || style="padding: 5px 5px; background: #F5F5F5;" |-|| style="padding: 5px 5px; background: #F5F5F5;" |1 drug|| style="padding: 5px 5px; background: #F5F5F5;" |2 or more drugs | ||
|} | |} | ||
==References== | ==References== | ||
{{Reflist| | {{Reflist|2}} | ||
[[Category:Types of cancer]] | [[Category:Types of cancer]] | ||
[[Category:Gynecology]] | [[Category:Gynecology]] | ||
[[Category:Up-To-Date]] | |||
[[Category:Oncology]] | |||
[[Category:Medicine]] | |||
[[Category:Gynecology]] | |||
[[Category:Surgery]] |
Latest revision as of 20:12, 11 March 2019
Gestational trophoblastic neoplasia Microchapters |
Differentiating Gestational trophoblastic neoplasia from other Diseases |
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Diagnosis |
Treatment |
Case Studies |
Gestational trophoblastic neoplasia staging On the Web |
American Roentgen Ray Society Images of Gestational trophoblastic neoplasia staging |
Directions to Hospitals Treating Gestational trophoblastic neoplasia |
Risk calculators and risk factors for 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 |
|
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.