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    Gestational Trophoblastic Disease Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information for Gestational Trophoblastic Disease

    Hydatidiform Mole (HM)

    HM (molar pregnancy) is disease limited to the uterine cavity.

    Gestational Trophoblastic Neoplasia

    Definitions: FIGO

    The Féderation Internationale de Gynécologie et d'Obstétrique (FIGO) and the American Joint Committee on Cancer (AJCC) have designated staging to define gestational trophoblastic neoplasia; the FIGO system is most commonly used.[1,2] Some tumor registrars encourage the recording of staging in both systems.

    FIGO staging system (and modified World Health Organization [WHO] prognostic scoring system)

    The FIGO staging system is as follows:[1]

    Table 1. Gestational Trophoblastic Neoplasia (GTN)a,b

    FIGO Anatomical Staging
    FIGO = Féderation Internationale de Gynécologie et d'Obstétrique; hCG = human chorionic gonadotropin; iu = international unit; WHO = World Health Organization.
    a Adapted from FIGO Committee on Gynecologic Oncology.[1]
    b To stage and allot a risk factor score, a patient's diagnosis is allocated to a stage as represented by a Roman numeral I, II, III, and IV. This is then separated by a colon from the sum of all the actual risk factor scores expressed in Arabic numerals, i.e., stage II:4, stage IV:9. This stage and score will be allotted for each patient.
    I Disease confined to the uterus.
    II GTN extends outside of the uterus, but is limited to the genital structures (adnexa, vagina, broad ligament).
    III GTN extends to the lungs, with or without known genital tract involvement.
    IV All other metastatic sites.
    Modified WHO Prognostic Scoring System as Adapted by FIGOb
    Scores 0 1 2 4
    Age <40 ≥40 - -
    Antecedent pregnancy mole abortion term -
    Interval months from index pregnancy <4 4-6 7-12 >12
    Pretreatment serum hCG (iu/1) <103 103 -104 104 -105 >105
    Largest tumor size (including uterus) <3 3-4 cm ≥5 cm -
    Site of metastases lung spleen, kidney gastrointestinal liver, brain
    Number of metastases - 1-4 5-8 >8
    Previous failed chemotherapy - - single drug ≥2 drugs

    In addition, the FIGO staging system incorporates a modified WHO prognostic scoring system. The scores from the eight risk factors are summed and incorporated into the FIGO stage, separated by a colon (e.g., Stage II:4, Stage IV:9, etc.). Unfortunately, a variety of risk scoring systems have been published, making comparisons of results difficult.


    1. FIGO Committee on Gynecologic Oncology.: Current FIGO staging for cancer of the vagina, fallopian tube, ovary, and gestational trophoblastic neoplasia. Int J Gynaecol Obstet 105 (1): 3-4, 2009.
    2. Gestational trophoblastic tumors. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, p 439.

    This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http:// cancer .gov or call 1-800-4-CANCER.

    WebMD Public Information from the National Cancer Institute

    Last Updated: May 28, 2015
    This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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