Eysbouts, YK;
Ottevanger, PB;
Massuger, LFAG;
IntHout, J;
Short, D;
Harvey, R;
Kaur, B;
... Seckl, MJ; + view all
(2017)
Can the FIGO 2000 scoring system for gestational trophoblastic neoplasia (GTN) be simplified? A new retrospective analysis from a nationwide data-set.
Annals of Oncology
, 28
(8)
pp. 1856-1861.
10.1093/annonc/mdx211.
Preview |
Text
Sebire_mdx211.pdf - Accepted Version Download (548kB) | Preview |
Abstract
Background: Worldwide introduction of the FIGO 2000 scoring system has provided an effective means to stratify patients with gestational trophoblastic neoplasia (GTN) to single- or multi-agent chemotherapy. However, the system is quite elaborate with an extensive set of risk factors. In this study, we re-evaluate all prognostic risk factors involved in the FIGO 2000 scoring system and examine if simplification is feasible. Patients and methods: Between January 2003 and December 2012, 813 patients diagnosed with GTN were identified at the Trophoblastic Disease Centre in London and scored using the FIGO 2000. Multivariable analysis and stepwise logistic regression were carried out to evaluate if the FIGO 2000 scoring system could be simplified. Results: Of the eight FIGO risk factors only pre-treatment serum human chorionic gonadotropin (hCG) levels exceeding 10,000 IU/l (OR = 5.0; CI 2.5-10.4) and 100,000 IU/l (OR = 14.3; CI 4.7-44.1), interval exceeding 7 months since antecedent pregnancy (OR = 4.1; CI 1.0-16.2) and tumor size of over 5 cm (OR = 2.2; CI 1.3-3.6) were identified as independently predictive for single-agent resistance. In addition, increased risk was apparent for antecedent term pregnancy (OR = 3.4; CI 0.9-12.7) and the presence of 5 or more metastases (OR = 3.5; CI 0.4-30.4), but patient numbers in these categories were relatively small. Stepwise logistic regression identified a simplified risk scoring model comprising age, pre-treatment serum hCG, number of metastases, antecedent pregnancy and interval but omitting tumor size, previous failed chemotherapy and site of metastases. With this model only 1 of 725 patients was classified differently from the FIGO 2000 system. Conclusion: Our simplified alternative using only five of the FIGO prognostic factors appears to be an accurate system for discriminating patients requiring single as opposed to multi-agent chemotherapy. Further work is urgently needed to validate these findings.
| Type: | Article |
|---|---|
| Title: | Can the FIGO 2000 scoring system for gestational trophoblastic neoplasia (GTN) be simplified? A new retrospective analysis from a nationwide data-set |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1093/annonc/mdx211 |
| Publisher version: | http://doi.org/10.1093/annonc/mdx211 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Gestational Trophoblastic Neoplasia, classification, staging, FIGO, risk factors |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1558971 |
Archive Staff Only
 |
View Item |
