BACKGROUND: @entity1469 include premalignant (partial and complete hydatidiform moles) and malignant entities referred to as @entity1469 . Use of the International Federation of Gynecology and Obstetrics prognostic score is encouraged in cases of @entity1469 to predict the potential for the development of resistance to single-agent chemotherapy. An International Federation of Gynecology and Obstetrics score of >= 7 defines a high-risk @entity1 and requires combination chemotherapy. Appropriate and rapid diagnosis, treatment by specialized centers, and @entity204 at the time of chemotherapy initiation have led to significant improvements in survival for @entity1 with high-risk @entity1469 . There is a crucial need for the early identification of high-risk @entity1 with @entity1469 who have an increased @entity204 risk to organize their treatment in highly specialized centers. OBJECTIVES: The purpose of this study was to describe cases of @entity1469 that have resulted in @entity204 , particularly in a subgroup with an International Federation of Gynecology and Obstetrics prognostic score of >= 13, for whom low-dose @entity2879 and @entity900 induction chemotherapy recently was shown to reduce @entity204 rate. STUDY DESIGN: We identified 974 @entity1 from the French Center for Trophoblastic Diseases who had a diagnosis of @entity1469 from November 1999 to March 2014. Among 140 @entity1 who were at high risk of resistance to single-agent chemotherapy (International Federation of Gynecology and Obstetrics score, >= 7), 29 @entity1 (21%) had a score of >= 13. Mortality rate was estimated with the use of the Kaplan-Meier method. RESULTS: The 5-year overall mortality rate, after the exclusion of @entity1470 and @entity3567 , was 2% for @entity1 with @entity1469 (95% confidence interval, 1.25-3.13%). High-risk @entity1 had a 5-year mortality rate of 12% (95% confidence interval, 7.49-18.9%). @entity1 with an  International Federation of Gynecology and Obstetrics score of >= 13 had a  higher 5-year mortality rate (38.4%; 95% confidence interval, 23.4-58.6%) and accounted for 52% of the deaths in the entire cohort. Early deaths, defined as those that occur within 4 weeks after treatment initiation, occurred in 8 @entity1 of the entire cohort. Six of them had an International Federation of Gynecology and Obstetrics score of >= 13 at presentation, of whom 5 @entity1 had brain and/or liver metastases. CONCLUSION: @entity1469 with an International Federation of Gynecology and Obstetrics score of >= 13 have an increased risk of @entity204 . We suggest that an International Federation of Gynecology and Obstetrics score of >= 13 becomes a consensual criterion for prediction of @entity1 with @entity1469 with increased risk of @entity204 , particularly @entity204 . These @entity1 justify treatment in highly specialized @entity1469 centers and may benefit from the use of induction low-dose @entity2879 and @entity900 .

Mortality rate of XXXX with a FIGO score of >= 13.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity900 :: ('MESH:D002945', 'Chemical') :: ['cisplatin'] @entity1469 :: ('MESH:D031901', 'Disease') :: ['gestational trophoblastic disease', 'gestational trophoblastic neoplasia', 'Gestational trophoblastic diseases'] @entity2879 :: ('MESH:D005047', 'Chemical') :: ['etoposide'] @entity1470 :: ('MESH:D018245', 'Disease') :: ['placental site trophoblastic tumors'] @entity3567 :: ('MESH:D014328', 'Disease') :: ['epithelioid trophoblastic tumors'] @entity204 :: ('MESH:D003643', 'Disease') :: ['early death', 'reduction of early deaths', 'death']
@entity1469 :: (MESH:D031901,Disease) :: ['gestational trophoblastic neoplasia']
