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Diagnosis

Staging of gestational trophoblastic disease

The stage of gestational trophoblastic disease is a term used to describe its size and whether it has spread beyond its original area of the body.

Knowing the type and stage helps the doctors to decide on the most appropriate treatment.

The following stages are used for gestational trophoblastic disease:

  • Hydatidiform mole: The tumour is found only in the space inside the uterus. If the tumour is found in the muscle of the uterus, it is called an invasive mole.
  • Placental-site gestational trophoblastic tumour: Cancer is found in the place where the placenta was attached and in the muscle of the uterus.
  • Nonmetastatic gestational trophoblastic neoplasia: Cancer cells have grown inside the uterus from tissue remaining following treatment of a hydatidiform mole or following an abortion or delivery of a baby. Cancer has not spread outside the uterus.
  • Metastatic gestational trophoblastic neoplasia, good prognosis: Cancer cells have grown inside the uterus from tissue remaining following treatment of a hydatidiform mole or following an abortion or delivery of a baby. The cancer has spread from the uterus to other parts of the body. Metastatic gestational trophoblastic neoplasia is considered good prognosis if all of the following are true:
  • The last pregnancy was less than four months ago.
  • The level of hCG (a hormone normally found in the blood and urine during pregnancy) in the blood is low.
  • Cancer has not spread to the liver or brain.
  • The patient has not received chemotherapy earlier.
  • Metastatic gestational trophoblastic neoplasia, poor prognosis: Cancer cells have grown inside the uterus from tissue remaining following treatment of a hydatidiform mole or following an abortion or delivery of a baby. The cancer has spread from the uterus to other parts of the body. Metastatic gestational trophoblastic disease is considered poor prognosis if any the following are true:
  • The last pregnancy was more than four months ago.
  • The level of hCG (a hormone normally found in the blood and urine during pregnancy) in the blood is high.
  • Cancer has spread to the liver or brain.
  • The patient received chemotherapy earlier and the cancer did not go away.
  • The tumour began after the completion of a normal pregnancy.

If gestational trophoblastic disease comes back after initial treatment, this is known as recurrent disease. Gestational trophoblastic disease may come back in the uterus or in another part of the body.