🎗️ GTN WHO/FIGO Prognostic Score
Stratify gestational trophoblastic neoplasia with the WHO/FIGO prognostic score.
Clinical takeaway
Low risk → single-agent (methotrexate/actinomycin D).
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When to use
Decide between single-agent and combination chemotherapy in GTN.
How it works
Sum 8 factors (age, antecedent pregnancy, interval, hCG, tumor size, metastatic site, number of metastases, prior failed chemo). ≤ 6 low risk, ≥ 7 high risk.
Key points
- Low risk → single-agent (methotrexate/actinomycin D).
- High risk → combination chemotherapy (e.g. EMA-CO).
- Expressed with the FIGO anatomic stage; not for PSTT/ETT.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Age | < 40 y (0) |
|---|---|
| Antecedent pregnancy | Hydatidiform mole (0) |
| Interval from antecedent pregnancy (months) | < 4 (0) |
| Pretreatment serum hCG (IU/L) | < 10³ (0) |
| Largest tumor (incl. uterus) | < 3 cm (0) |
| Site of metastases | Lung (0) |
| Number of metastases | 0 (0) |
| Prior failed chemotherapy | None (0) |
→FIGO score0
- Prognostic score：0 → Low risk (≤ 6)
- Treatment：Low-risk GTN: single-agent chemotherapy (methotrexate or actinomycin D); switch agent or escalate if resistant
- Note：Expressed with the FIGO anatomic stage (e.g. III:5); does not apply to PSTT or epithelioid trophoblastic tumor
| Age | ≥ 40 y (1) |
|---|---|
| Antecedent pregnancy | Term pregnancy (2) |
| Interval from antecedent pregnancy (months) | > 12 (4) |
| Pretreatment serum hCG (IU/L) | > 10⁵ (4) |
| Largest tumor (incl. uterus) | ≥ 5 cm (2) |
| Site of metastases | Liver/brain (4) |
| Number of metastases | > 8 (4) |
| Prior failed chemotherapy | ≥ 2 drugs (4) |
→FIGO score25
- Prognostic score：25 → High risk (≥ 7)
- Treatment：High-risk GTN: combination chemotherapy (e.g. EMA-CO), salvage and multidisciplinary care as needed; individualized treatment for brain/liver metastases
- Note：Expressed with the FIGO anatomic stage (e.g. III:5); does not apply to PSTT or epithelioid trophoblastic tumor
Frequently asked questions
- What is GTN WHO/FIGO Prognostic Score?
- Stratify gestational trophoblastic neoplasia with the WHO/FIGO prognostic score.
- How is GTN WHO/FIGO Prognostic Score calculated? What is the core formula?
- Sum 8 factors (age, antecedent pregnancy, interval, hCG, tumor size, metastatic site, number of metastases, prior failed chemo). ≤ 6 low risk, ≥ 7 high risk.
- When is GTN WHO/FIGO Prognostic Score used?
- Decide between single-agent and combination chemotherapy in GTN.
- What are the key clinical points for GTN WHO/FIGO Prognostic Score?
- Low risk → single-agent (methotrexate/actinomycin D). High risk → combination chemotherapy (e.g. EMA-CO). Expressed with the FIGO anatomic stage; not for PSTT/ETT.
- What are the limits and cautions when using GTN WHO/FIGO Prognostic Score?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is GTN WHO/FIGO Prognostic Score calculated in practice? Can you show a worked example?
- Inputs: Age < 40 y (0), Antecedent pregnancy Hydatidiform mole (0), Interval from antecedent pregnancy (months) < 4 (0), Pretreatment serum hCG (IU/L) < 10³ (0), Largest tumor (incl. uterus) < 3 cm (0), Site of metastases Lung (0), Number of metastases 0 (0), Prior failed chemotherapy None (0) → Result: FIGO score 0（Prognostic score: 0 → Low risk (≤ 6), Treatment: Low-risk GTN: single-agent chemotherapy (methotrexate or actinomycin D); switch agent or escalate if resistant, Note: Expressed with the FIGO anatomic stage (e.g. III:5); does not apply to PSTT or epithelioid trophoblastic tumor） Inputs: Age ≥ 40 y (1), Antecedent pregnancy Term pregnancy (2), Interval from antecedent pregnancy (months) > 12 (4), Pretreatment serum hCG (IU/L) > 10⁵ (4), Largest tumor (incl. uterus) ≥ 5 cm (2), Site of metastases Liver/brain (4), Number of metastases > 8 (4), Prior failed chemotherapy ≥ 2 drugs (4) → Result: FIGO score 25（Prognostic score: 25 → High risk (≥ 7), Treatment: High-risk GTN: combination chemotherapy (e.g. EMA-CO), salvage and multidisciplinary care as needed; individualized treatment for brain/liver metastases, Note: Expressed with the FIGO anatomic stage (e.g. III:5); does not apply to PSTT or epithelioid trophoblastic tumor）