According to FIGO 2000 scoring system for gestational trophoblastic neoplasia (GTN), a patient has a non-metastatic post-molar GTN at 8 weeks after antecedent pregnancy with β-hCG of 65,000 IU/L and no prior chemotherapy. What is her FIGO/WHO risk score?

• A Score 4 — low risk
• B Score 7 — high risk
• C Score 2 — low risk ✓
• D Score 5 — low risk (score ≤ 6 is low risk)

Explanation

FIGO/WHO prognostic score for GTN sums seven items: age < 40 = 0; antecedent pregnancy hydatidiform mole = 0; interval from index pregnancy < 4 months (here 8 weeks ≈ 2 months) = 0; pretreatment β-hCG 10,000–99,999 IU/L (here 65,000) = 2; largest tumour < 3 cm = 0; no metastases (site and number) = 0; no prior chemotherapy = 0. Total = 2. A score ≤ 6 is low-risk and is treated with single-agent chemotherapy (methotrexate or actinomycin-D); a score ≥ 7 is high-risk requiring multi-agent EMA-CO.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.