Question

Prognostic score in GTN.

Hint:

The FIGO scoring system is essential in predicting the prognosis of GTN, helping clinicians tailor the treatment and follow-up for each patient.

Answer 1

The prognosis of Gestational Trophoblastic Neoplasia (GTN) is assessed using a scoring system that helps predict the likelihood of disease progression and the success of treatment. The most widely used scoring system is the FIGO (International Federation of Gynecology and Obstetrics) scoring system.
Step 1: The FIGO Scoring System:
1. Criteria: The FIGO score is based on the following factors: age of the patient, interval from the index pregnancy, pre-treatment serum beta-hCG levels, size and site of the tumor, and the presence of metastasis.
2. Risk Stratification: The total score classifies patients into low-risk and high-risk categories. A higher score indicates a greater risk of resistance to treatment and poorer prognosis.
Step 2: High-Risk Prognostic Factors:
1. High beta-hCG levels: Extremely elevated beta-hCG levels are associated with a worse prognosis.
2. Metastatic Disease: The presence of metastasis to vital organs such as the lungs, liver, or brain is associated with a higher risk.
3. Large tumor size: Larger tumors tend to be more resistant to treatment and are linked to a poorer prognosis.
Step 3: Treatment and Follow-Up:
Prognostic scoring helps determine the appropriate treatment approach and frequency of monitoring. Patients with high-risk scores require more aggressive treatment, often with a combination of chemotherapy and other modalities.