An evaluation of FIGO 2000: the first 5 years.
OBJECTIVE
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.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Okines
Alicia F C
AF
Department of Medicine, The Royal Marsden Hospital, Sutton, Surrey, UK.
Morris
Richard
R
Hancock
Barry W
BW
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult
D000970:Antineoplastic Agents