Prognosis and survival for gestational trophoblastic disease
A prognosis is the doctor’s best estimate of how cancer will affect you and how it will respond to treatment. Survival is the percentage of people with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many factors.
The doctor will look at certain aspects of the cancer as well as characteristics of the person (such as your age, if you had any problems with previous pregnancies and number of months since your last pregnancy). These are called prognostic factors. The doctor will also look at predictive factors, which influence how a cancer will respond to a certain treatment and how likely it is that the cancer will come back after treatment.
Prognostic and predictive factors are often discussed together. They both play a part in deciding on a prognosis and a treatment plan just for you. Only a doctor familiar with your medical history, the type, the stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis and chances of survival.
Cancerous gestational trophoblastic disease (GTD) is also called gestational trophoblastic neoplasia (GTN). In general, both cancerous and non-cancerous types of GTD can be treated and have very good survival.
Prognostic score
The World Health Organization (WHO) prognostic scoring system is a tool that may help your healthcare team determine your treatment plan and prognosis for cancerous GTD. This scoring system applies to invasive mole and gestational choriocarcinoma. It doesn’t apply to placental site trophoblastic tumours (PSTTs) or epithelioid trophoblastic tumours (ETTs).
The scoring system is based on several prognostic factors. It gives a score of 0, 1, 2 or 4 to each prognostic factor. All scores are added together to give an overall prognostic score. This is used to group cancerous GTD as low risk or high risk.
Low-risk cancerous GTD has a prognostic score of 6 or less. It often responds well to treatment and has a very high survival rate. Low-risk cancerous GTD tends to have a good prognosis even if it has spread.
High-risk cancerous GTD has a prognostic score of 7 or more. It may not respond to treatment as well as low-risk cancerous GTD does, so it may need more or different treatments. High-risk cancerous GTD that hasn’t spread has a good prognosis. High-risk GTD that has spread is usually successfully treated too.
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