According to FIGO 2000 scoring system for gestational trophoblastic neoplasia (GTN), a patient with choriocarcinoma, pre-treatment hCG of 150,000 IU/L, uterine disease only, largest tumor 5 cm, and no prior chemotherapy has a FIGO risk score most consistent with:
- A Low risk (score ≤6)
- B Ultra-high risk (score ≥12)
- C High risk (score ≥7) ✓
- D Cannot be scored without metastasis count
Correct answer: C. High risk (score ≥7)
Explanation
FIGO 2000 scoring assigns: age ≥40 = 1 point; antecedent pregnancy: choriocarcinoma = 4 points; interval <4 months = 0, 4–6 months = 1; hCG >100,000 = 4 points; tumor size 3–5 cm = 1 point; uterine only = 0; no prior chemo = 0. Score here is approximately 4 (choriocarcinoma) + 4 (hCG >100,000) + 1 (tumor 5 cm) = 9, which is high risk (≥7), requiring multi-agent chemotherapy (EMA-CO regimen). Low risk (≤6) is treated with single-agent methotrexate or actinomycin-D.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.