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KMID : 0375219940090010065
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Journal of Il Sin Christian Hospital
1994 Volume.9 No. 1 p.65 ~ p.78
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Comparison of the Reliability of FIGO Staging and Prognostic Score in Gestational Trophoblastic Tumor(CTT)
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김정혜
박승희/하현미/김양희/민보은
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Abstract
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a retrospective study of 129patients(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 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 In 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 4pts in c subgroup were high risk.
When the cases were considered from the prognostic score aspect, in the low risk group 60/82(73%) were stage Ia but 17/82(21%) were stage IIIa, in the high risk group 11/26 were stage III or IV but 12 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. Overall initial tretment was appropriate in 76.4%.
Some pts however became resistant to single drug therapy, 29% of low risk and 42% of med risk, or 24% of ia and 45% of IIIa. On analysis it was found that I patients without either of the two FIGO staging risk factors only 3/18 pts in whom the
HCG
titre
was above 10E4 responded to single therapy.
Both the prognostic score and FIGO staging were then modified using HCG 10E4 and above as a high risk factor and the treatment given was then reevaluated. If single therapy treatment had only been given to those in low risk group or "a" subgroups
of
FIGO staging and all others been given multiple therapy treatment would have been appropriate in 81.9% of cases treated according to the prognostic score and 80.3% of those treated according to FIGO stage.
Conclusion-Risk factors are more important that the anatomical stage and FIGO staging does not seem to have any advantage over prognostic score.
An HCG tire of 10E4 rather than 10E5 is a better cut off line between low/medium, high risk groups and a/b, c sub groups.
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KEYWORD
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