A retrospective study of 129 patients (pts) with GTT admitted to Il sin Christian Hospital between Jan. 1983 and Dec. 1992 was done to assess and compare the reliability of both the 1983 WHO prognostic score(Prog. score) and 1992 FIGO Staging in
determining the severity of the disease and therefore the outcome and method of treatment needed.
The overall remission rate was 93.8%.
The addition of 2 risk factors, HCG titer 10E5 and above and interval of 6 months or more to separate each stage into a, b, c subgroups (none, one, or both risk factors) greatly improved the correlation with the prognostic score(r=0.595) compared
to the
previously purely anatomically staging (r=0.460). 60/66(91%) of stage Ia and 17/21(81%) of stage IIIa pts were low risk but 11/21(52%) of stage Ib and 5/6(83%) of stage IIIb were high risk, all 4 pts in c subgroup were high risk. When cases were
considered from the prognostic score aspect, 60/82(73%) of low risk were stage Ia but 17/82(21%) were stage IIIa, 11/29 pts of high risk pts were stage III or IV and 12 pts were stage. I
Treatment was determined according to the prognostic score and apart from a few pts, low risk pts were given single therapy and med/high risk pts multiple therapy. Some pts became resistent to single therpy and 29% of low risk, 42% of med, risk
pts
and
24% of la and 43% of IIIa pts had to be changed to multiple therapy.
The outcome of the treatment given was then evaluated, as if the guide lines of single therpy for low risk, and multiple therpy for medium/high risk cases had been strictly followed for the initial treatment on comparing the two modified score,
there
would had been moderate increase 81.9% appropriate treatment compared 76.4%.
In conclusion risk factors seem to be more important than the anatomical stage in determining severity of diseases.
In addition an HCG titre of 10E4 or more may be a better indicator to separate the stage than the titer of 10E5
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