The Japanese trophoblastic disease classification.

OBJECTIVE

To evaluate the clinical usefulness of the "diagnostic score"for the detection of choriocarcinoma in persistent gestational trophoblastic disease without histologic findings.

STUDY DESIGN

We reviewed the clinical records of and histologic reports on all 809 patients with persistent gestational trophoblastic disease treated with surgery and chemotherapy in Japan. There were 347 cases of choriocarcinoma and 462 cases of invasive mole with histologic confirmation. We retrospectively applied the diagnostic score to all the patients.

RESULTS

The sensitivity of the score for choriocarcinoma (the true positive rate of the score for histologic diagnosis of choriocarcinoma) was 91.4%. The specificity of the score (the true positive rate of the score for the histologic diagnosis of invasive mole) was 94.1%. The accuracy of the score was 92.8%.

CONCLUSION

The diagnostic score is a unique scoring system for differentiating choriocarcinoma clinically from persistent gestational trophoblastic disease without histologic findings and for selecting the most appropriate chemotherapy. Proper management in the early stages strongly influences the outcome of these diseases. The scoring system should be very useful for comparing the nearly true incidence and treatment results with choriocarcinoma between nations.