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What is Good prognosis in gestational trophoblastic disease is seen with which organ metastasis? and explain in detail?
Ans. is 'd' i.e., Lung Gestational Trophoblastic Disease:i) Low risk (Good Prognosis):# Disease is present < 4 months duration# Initial serum hCG level < 40,000 mIU/ml# Metastasis limited to lung and vagina# No prior chemotherapy# No preceding term deliveryii) High Risk (Poor Prognosis):# Long duration of disease (> 4 months)# Initial serum hCG level > 40,000 mIU/ml# Brain or liver metastasis# Failure of prior chemotherapy# Following term pregnancy# WHO score > 8WHO Prognostic Scoring System for GTTPrognostic factors0124Age<39>39 Blood groupOO or AB or AB Prior failed chemotherapy Single drug2 or more drugsInterval (months) between end of antecedent pregnancy & start of chemotherapy<44-67-12>12hCG levels (mIU/ml)<103103- 104104-105>105Antecedent PregnancyMoleAbortionTerm pregnancy Size of tumor (cm)<3 cm3-5cm>5 cm Number of metastasis 1-45-8>8Site of metastasisLungSpleen, kidneyGILiver, brain< 4 - Low risk; 5 - 8 - Middle risk; > 8 - High Risk