An evaluation of FIGO 2000: the first 5 years

To evaluate the International Federation of Gynecology and Obstetrics 2000 Gestational Trophoblastic Neoplasia (GTN) staging and classification system and to identify any factors predictive of failure of first-line chemotherapy.

Patients registered at 1 center between January 2000 and December 2004 (n = 2,209) were identified from a dedicated database. Data were collected on all patients who received treatment for GTN at the center (n = 132). Survival analysis (Kaplan Meier method) and chi2 tests were performed.

One hundred twenty-two eligible patients were identified. Of those, 38 of 107 (35.5%) of patients who scored as low risk and 2 of 15 (13.3%) of patients who scored as high risk required salvage chemotherapy. Three of 107 (2.8%) of low-risk patients and 3 of 15 (20%) of high-risk patients had salvage surgery. No statistically significant predictive factors for treatment failure were identified. There was a trend toward association with increased age at diagnosis: 48.8% of patients aged > or = 30 required second-line therapy compared to 33.3% aged < 30 (p = 0.098).

Approximately one third of women treated on the low-risk regimen will require salvage chemotherapy, but this does not affect their survival. Women aged > or = 30 may be at particular risk of treatment failure so could be offered high-risk chemotherapy from the outset.