A staging system of gestational trophoblastic neoplasms based on the development of the disease
Song, H.Z.; Wu, B.Z.; Tang, M.Y.; Wang, Y.E.; Yang, X.Y.
Chinese Medical Journal 97(8): 557-566
1984
ISSN/ISBN: 0366-6999 PMID: 6097412 Document Number: 226441
Based on an intensive study of the development of malignant gestational trophoblastic neoplasms, a system for clinical staging is proposed. The process of development involves 4 steps. The disease begins in the uterus and then invades the parametrium, adnexa and/or vagina. From the pelvic organs, the tumor spreads along the venous pathway to the lungs. From the pulmonary metastases, the tumor cells may further disseminate, through the circulation, to other organs and tissues. These observations constitute the basis of the present staging system for malignant gestational trophoblastic disease. When the lesion is limited to the uterus, it is categorized as stage I. When it has extended outside of the uterus but is still confined to the genital organs, it is categorized as stage II. As it metastasizes into the lungs, it is categorized as stage III. When it develops into generalized metastases following pulmonary lesions, it is categorized as stage IV. Through long-term clinical use and recent reevaluation, this classification has proved simple, rational and practical, and it meets all the purposes of a clinical staging system.