Carcinoma of the Fallopian Tube
Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.Journal of Epidemiology and Biostatistics 02/2001; 6(1):89-103. DOI: 10.1016/S0020-7292(06)60032-5
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ABSTRACT: The objective of this retrospective multicenter study was to assess the pattern of failures and survival of patients with primary carcinoma of the fallopian tube. The hospital records of 88 patients with primary carcinoma of the fallopian tube were reviewed. Surgery was the initial therapy for all patients. Tumor stage was I in 21 (23.9%), II in 21 (23.9%), III in 43 (48.8%), and IV in 3 (3.4%) patients. Postoperative treatment was given without well-defined protocols. The median follow-up of survivors was 55 months (range, 7-182). Of the 21 patients with stage I disease, 10 had no postoperative treatment and 11 had platinum-based chemotherapy. Five (23.8%) patients recurred after a median of 29 months (range, 8-93) from initial surgery. Of the 21 patients with stage II disease, 2 had no postoperative treatment, 2 underwent external pelvic irradiation, 16 received platinum-based chemotherapy, and 1 patient had oral melphalan. Eight (38.1%) patients recurred after a median of 25.5 months (range, 7-57). Of the 46 patients with stage III-IV disease, 1 patient refused chemotherapy and died after 19 months and 45 patients received platinum-based chemotherapy. A clinical complete response was obtained in 29 (64.4%) patients and a partial response in 8 (17.8%). A second-look laparotomy was performed in 14 of the 29 clinically complete responders: 12 patients were found to be in pathological complete response and 2 had persistent disease. Six (50.0%) of the former recurred after a median of 22 months (range, 13-101) from initial surgery. The two patients with persistent disease developed tumor progression after 15 and 11 months, respectively. Fifteen clinically complete responders did not undergo second-look, and 7 (46.7%) of them had a recurrence after a median of 18 months (range, 9-41). For the whole series, 5-year survival was 57%. By log-rank test, survival was related to FIGO stage (III-IV vs I-II, P = 0.0001), tumor grade (G3 vs G1 + G2, P = 0.0038), and patient age (>58.5 years vs <58.5 years, P = 0.0069), but not to histological type. The Cox model showed that FIGO stage (P = 0.0018) and patient age (P = 0.0290) were independent prognostic variables for survival. Among the patients with stage III-IV disease, 5-year survival was 55% for the patients who had residual tumor <1 cm compared with 21% for those who had larger residuum (P = 0.0169). Primary carcinoma of the fallopian tube shares several biological and clinical features with ovarian carcinoma. However, when compared with the latter, fallopian tube carcinoma more often tends to recur in retroperitoneal nodes and distant sites. Stage, patient age, and, among patients with advanced disease, residual tumor after initial surgery represent important prognostic variables for survival.Gynecologic Oncology 06/2001; 81(2):150-9. DOI:10.1006/gyno.2001.6134 · 3.77 Impact Factor
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ABSTRACT: Objective:The aim of the current study is to review the experience of the Gynaecology Department of Zaragoza’s Miguel Servet University Hospital with primary cancer of the fallopian tube.Materials and methods:We review 9 cases of primary tubal carcinoma treated and followed up in our hospital between the first of January 1995 and the thirtieth of June 2003.Results:According to the FIGO staging system 2 patients were stage IA, 2 stage IC, 2 stage IIIA, 2 stage IIIC and 1 stage IV. All patients underwent initial surgery and 7 received adjuvant chemotherapy; no one received radiotherapy. There was preoperative suspicion in only one case, and in all patients the histological type was serous papillary adenocarcinoma. The follow up period ranged from 9 to 95 months, with an average of 52 months. Two patients died of the disease after 12 and 42 months of follow up, 2 patients are alive with persistent disease and 5 are alive with no evidence of disease.Conclusions:Fallopian tube carcinoma is a tumor which is difficult to diagnose preoperatively, whose most common presenting symptoms are abnormal vaginal bleeding and pelvic pain. Treatment is mainly surgical, and following the same principles as in ovarian carcinoma is recommended.Clínica e Investigación en Ginecología y Obstetricia 01/2004; 31(7):237–243. DOI:10.1016/S0210-573X(04)77341-4
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ABSTRACT: To analyze the clinicopathologic features of women with primary fallopian tube carcinoma Descriptive cross sectional study Twenty-eight women diagnosed with primary fallopian tube carcinoma treated at Chiang Mai University Hospital between January 1997 and December 2004. During the study period, the primary fallopian tube carcinoma accounted for 0.48% of all gynecologic malignancies. Of the 28 patients, one was excluded for unavailable medical records. Mean age at diagnosis was 53 years (range, 38-76 years). Seventeen (63.0%) were menopausal women. The most common clinical presentation was pelvic mass (55%), followed by abnormal vaginal bleeding (18.5%). Hydrops tubae profluens was present in three (11.1%) women. The rare presenting symptoms included pelvic peritonitis and abnormal glandular cells on cervicovaginal smear were noted in one (3.7%) woman of each category. In all women, primary fallopian tube carcinoma could not be diagnosed preoperatively. During the operation, an abnormal tubal lesion was suspected in only eleven (40.7%) women. Histology were serous adenocarcinoma (70.4%), endometrioid adenocarcinoma (22.2%), undifferentiated adenocarcinoma (3.77%) and carcinosarcoma (3.7%). As opposed to epithelial ovarian cancer, the majority of women in the present study were in the early stages of the disease. Primary fallopian tube carcinoma is a rare gynecologic malignancy that has various and nonspecific presentations. Definite diagnosis is usually made postoperatively. This malignancy should be considered in differential diagnosis of peri- and postmenopausal women who present with complex adnexal mass, unexplained uterine bleeding, abnormal glandular cells on cervicovaginal smear and complicated pelvic inflammatory disease.Journal of the Medical Association of Thailand = Chotmaihet thangphaet 11/2005; 88(10):1338-43.
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