WHO prognostic score for a high-risk GTN is: (A) >= 6, (B) >= 7, (C) >= 10, (D) >= 15
Answer is B. Modified World Health Organization Prognostic Scoring System, as Adapted by FIGO, by which women whose score is 0-6 are Considered Low Risk (Requiring Single-Agent Chemotherapy) and score of 7 or more, High Risk (Requiring Multiagent Combination Chemotherapy)Scores0123Age<40>= 40----Antecedent pregnancyMoleAboionTerm--Interval months from index pregnancy<44-67-13>= 13Pretreatment serum hCG<10001000-1000010,000-100,000>100,000Largest tumor size --3-5 cm>= 5 cm--Site of metastasesLungSpleen, liverGastrointestinalLiver, brainNo. of metastases--1-45-8>8Previous failed chemotherapy----Single drug>= 2 DrugsReference: William's Obstetrics; 25th edition, chapter 20; Gestational trophoblastic diseases