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TNM and Stage Groupings > Gestational Trophoblastic Tumor
Gestational Trophoblastic Tumor
Primary Tumor (T)
| T Category |
Stage Category Definitions |
| TX |
Primary tumor cannot be assessed |
| T0 |
No evidence of primary tumor |
| T1 |
Tumor confined to uterus |
| T2 |
Tumor extends to other genital structures (ovary, tube, vagina, broad ligaments)
by metastasis or direct extension |
Regional Lymph Nodes (N)
| N Category |
Stage Category Definitions |
There is no regional nodal designation in the staging of these tumors. Nodal
metastases should be classified as metastatic (M1) disease.
Distant Metastasis (M)
| M Category |
Stage Category Definitions |
| M1 |
Distant metastasis |
| M1a |
Lung metastasis |
| M1b |
All other distant metastasis |
No distant metastasis (no pathologic M0; use clinical M to complete stage group)
Anatomic Stage/Prognostic Groups
| Stage |
T |
N |
M |
Risk Score |
| I |
T1 |
|
M0 |
Unknown |
| IA |
T1 |
|
M0 |
Low risk |
| IB |
T1 |
|
M0 |
High risk |
| II |
T2 |
|
M0 |
Unknown |
| IIA |
T2 |
|
M0 |
Low risk |
| IIB |
T2 |
|
M0 |
High risk |
| III |
Any T |
|
M1a |
Unknown |
| IIIA |
Any T |
|
M1a |
Low risk |
| IIIB |
Any T |
|
M1a |
High risk |
| IV |
Any T |
|
M1b |
Unkown |
| IVA |
Any T |
|
M1b |
Low risk |
| IVB |
Any T |
|
M1b |
High risk |
Prognostic Risk Scoring Index
| Pronostic Factor |
Risk Score 0 |
Risk Score 1 |
Risk Score 2 |
Risk Score 3 |
| Age |
<40 |
≥40 |
|
|
| Antecedent pregnancy |
Hydatidiform
mole |
Abortion |
Term pregnancy |
|
| Interval months from index pregnancy |
<4 |
4-6 |
7-12 |
>12 |
| Pretreatment hCG (IU/ml) |
<103 |
103-104 |
104-105 |
>105 |
| Largest tumor size, including uterus |
<3 cm |
3-5 cm |
>5 cm |
|
| Site of metastases |
Lung |
Spleen, kidney |
Gastrointestinal tract |
Brain, liver |
| Number of metastases identified |
|
1-4 |
5-8 |
>8 |
| Previous failed chemotherapy |
|
|
Single drug |
Two or more drugs |
Low risk is a score of 6 or less. High risk is a score of 7 or greater.
