FIGO Staging of Gestational Trophoblastic Neoplasia (GTN) and modified WHO Prognostic Scoring System as adapted by FIGO

Stage I	Disease confined to the uterus
Stage II	GTN extends outside of the uterus, but is limited to the genital structures (adnexa, vagina)
Stage III	GTN extends to the lungs, with or without genital tract involvement
Stage IV	All other metastatic sites
The stage should be followed by the sum of the risk factors (eg, III:5)

Risk factor	Score
Risk factor	0	1	2	4
Age (years)	<40	≥40	–	–
Antecedent pregnancy	Mole	Abortion	Term	–
Interval (months)*	4	4 to 6	7 to 12	>12
Pretreatment serum hCG (mIU/mL)	<10³	10³ to 10⁴	10⁴ to 10⁵	>10⁵
Largest tumor (including uterus)	<3 cm	3 to 4 cm	≥5 cm	–
Site of metastases	Lung^¶	Spleen, kidney	GI tract	Brain, liver
Number of metastases	–	1 to 4	5 to 8	>8
Prior failed chemotherapy	–	–	Single drug	≥2 drugs

FIGO: International Federation of Gynecology and Obstetrics; WHO: World Health Organization; hCG: human chorionic gonadotropin; GI: gastrointestinal.

* Interval (in months) between end of antecedent pregnancy and start of chemotherapy.

¶ The presence of lung metastases is assessed by conventional chest radiograph and not computed tomography.

Original figure modified for this publication. Berkowitz RS, Goldstein DP. Current management of gestational trophoblastic diseases. Gynecol Oncol 2009; 112:654. Table used with the permission of Elsevier Inc. All rights reserved.

Graphic 98185 Version 5.0

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FIGO Staging of Gestational Trophoblastic Neoplasia (GTN) and modified WHO Prognostic Scoring System as adapted by FIGO