A woman with GTN is scored on the WHO/FIGO prognostic system: antecedent complete mole (score 0), interval since index pregnancy 5 months (score 1), β-hCG 5,000 IU/L (score 1), tumour size 3 cm (score 1), no metastases (score 0), no prior chemotherapy (score 0). What is her total WHO score and classification?
- A Score 3; high risk — multi-agent EMA-CO required
- B Score 3; low risk — single-agent chemotherapy appropriate ✓
- C Score 6; borderline — clinical judgment required
- D Score 7; high risk — EMA-CO first-line
Correct answer: B. Score 3; low risk — single-agent chemotherapy appropriate
Explanation
WHO GTN scoring for this case: antecedent mole = 0; interval 5 months (4–6 months) = 1; β-hCG 5,000 IU/L (1,000–9,999 range) = 1; tumour size 3 cm (3–4 cm range) = 1; no metastases = 0; no prior chemo = 0. Total = 0+1+1+1+0+0 = 3. Score ≤6 is low-risk and is treated with single-agent chemotherapy (methotrexate or actinomycin D). Score ≥7 is high-risk requiring multi-agent EMA-CO.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.