Primary Carcinoma of the Fallopian Tube: A Review of a Single Institution Experience of 8 Cases

Shakuntala P Nanaiah,Bafna D Uttamchand,Praveen S Rathod,Anbukkani Subbian,Uma K Devi,Namrata N Rajkumar,Rajshekar Kundargi,Pallavi V Ramachandra,Abhilasha Narayan,Shobha Krishnappa

doi:10.1155/2014/630731

Shakuntala P Nanaiah, Bafna D Uttamchand + Show 8 more

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https://doi.org/10.1155/2014/630731

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Abstract

Aims and Objectives. To evaluate the clinicopathologic features, response to cytoreductive surgery and adjuvant platinum-based chemotherapy with or without paclitaxel. Materials and Methods. A retrospective observational study of 8 women with a histopathologic diagnosis of primary fallopian tube carcinoma (PFTC) from January 2000 to February 2013. Results. 4/8 (50%) of the women were in the early stage and an intraoperative frozen section was 100% effective in identifying fallopian tube carcinoma and then a staging laparotomy was performed. All 4/8 cases in the early stage had received and responded to single agent carboplatin and all are alive without clinical, radiological, or biochemical evidence of recurrence at the end of 2 years and the longest survivor has completed 13 years. Primary optimal cytoreductive surgery was achievable in 3/4 (75%) in advanced disease. All showed response to adjuvant paclitaxel and carboplatin (T+C), but all had succumbed to the disease following recurrence with mean progression-free survival of 19 months (range 15–21 months) and mean overall survival of 27 months (range 22–36 months). Conclusion. The pivotal role played by a frozen section in diagnosing PFTC which is rare needs to be reemphasized, therefore justifying a primary staging laparotomy in an early stage. Prolonged survival observed in this group following an optimum tailored adjuvant single agent carboplatin is worth noting.

Highlights

Primary fallopian tube carcinoma (PFTC) is rare and it accounts for only 0.3% to 1% of gynaecologic malignancies [1]
Close to 3000 women have been diagnosed as PFTC and described in the English medical literature [2,3,4,5,6,7,8]
(ii) role of adjuvant single agent carboplatin in early stage disease which is comprised of Stage IA, B, and C to Stage IIA, including all grades (G1, 2, and 3), (iii) the response to Cytoreductive surgery plus adjuvant paclitaxel with platinum-based chemotherapy in advanced stage disease which is comprised of Stage IIB–IVB and included all grades (G1, 2, 3), (iv) assess the progression-free and overall survival

Summary

Introduction

Primary fallopian tube carcinoma (PFTC) is rare and it accounts for only 0.3% to 1% of gynaecologic malignancies [1]. Alvarado-Cabrero et al proposed a modified staging system that subclassified stages IA and IB according to the depth of invasion within the wall of the tube as (a) no invasion, (b) invasion into the lamina propria or invasion into muscularis This modified system classified tumors which were located in the fimbrial end (noninvasive tumours) as stage IF, based on the capability of these lesions to metastasize into the peritoneal cavity even when noninvasive. This modified staging system reported enhanced prognostic significance of staging as demonstrated in the study published in 1999 [10]. The current FIGO staging system for fallopian tube cancers is still the same as the one published in 1991

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Conclusion