Trophoblastic diseases are staged according to FIGO (The International Federation of Gynecology and Obstetrics) and WHO (World Health Organization) risk scores.
Staging according to FIGO
Stage I: The tumor does not extend beyond the uterus.
Stage II: The tumor extends to the adnexa, parametria, or vagina.
Stage III: Lung metastases. Only lung metastases visible on conventional lung X-ray are included in the scoring system. Small metastases visible only on CT are not included, unless there are many of them.
Stage IV: Metastases to other localization.
|WHO risk score
|| < 4
|Serum h-CG (lU/L)**
|Largest tumor (cm)***
|Number of metastases
* The number of months from last finished pregnancy to start of chemotherapy
** hCG value at the time of initiation of treatment
*** Including tumor in uterus
**** Lung metastases are assessed on chest X-ray, not on CT
***** All metastases should be counted, regardless of localization
Low risk group: <=6
- Non-metastatic: Stage I
- Metastatic: > Stage I
High risk group: > 6
Placental-site trophoblastic tumors are a special disease group which are only classified according to FIGO stage.