A woman is diagnosed with low-risk non-metastatic gestational trophoblastic neoplasia (GTN) following molar evacuation. First-line chemotherapy is single-agent methotrexate. The WHO PROGNOSTIC SCORE that defines low-risk disease (requiring single-agent treatment) is:

• A WHO prognostic score of ≤4
• B WHO prognostic score of ≤8
• C WHO prognostic score of 0
• D WHO prognostic score of ≤6 ✓

Explanation

The modified WHO prognostic scoring system for GTN categorizes risk as: low-risk (score 0–6) treated with single-agent chemotherapy (methotrexate or actinomycin D), and high-risk (score ≥7) requiring combination chemotherapy (EMA-CO or similar). A score of ≤6 defines low-risk GTN eligible for single-agent treatment. Variables scored include age, antecedent pregnancy type, interval from index pregnancy, pre-treatment hCG, largest tumor size, site/number of metastases, and prior failed chemotherapy.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.