Carcinoma of the fallopian tube - Clinicopathologic study of 151 patients treated at the Norwegian Radium Hospital

BACKGROUND. The objective of the current study was to increase insight into the biology of fallopian tube carcinoma through an analysis of possible cl inical and pathologic determinants of prognosis and to formulate recommenda tions with regard to a more optimal therapeutic approach for patients with this rare disease. METHODS. A study was performed of the pathology specimens and clinical case records from 151 patients with fallopian tube carcinoma who were treated c onsecutively. Both univariate and multivariate analyses of possible prognos tic factors were performed for the whole group and for the subgroup of 41 p atients with Stage I disease. The possible significance of serum CA-125 lev els as a tumor marker and a marker of response to platinum-containing chemo therapy was evaluated. RESULTS. In multivariate analysis, disease stage, the presence of residual tumor, and a hydrosalpinx-like appearance of the fallopian tube were of ind ependent prognostic significance for the whole cohort. For patients with St age I disease, the depth of infiltration in the tubal wall and intraoperati ve tumor rupture were of independent prognostic significance. The marked te ndency of this disease for extraperitoneal spread, even in apparently early stages, was confirmed. In 37 evaluable, platinum-naive patients, an overal l response rate of 70% was obtained with platinum-based chemotherapy, with a median response duration of 12.5 months. In view of its low efficacy and high rate of serious complications, the use of postoperative radiotherapy i n the treatment of patients with fallopian tube carcinoma is no longer reco mmended. Serum CA-125 level Ineasurements in fallopian tube carcinoma patie nts have the same significance as tumor and surrogate markers of response a s in ovarian carcinoma patients. CONCLUSIONS. Prognostic factors in patients with early stage (Stages 0 and 1) fallopian tube carcinoma seem to differ from those in patients with earl y stage ovarian carcinoma. For patients with more advanced stage disease, d ue to the striking similarities in prognostic and clinical characteristics between the two diseases, the authors recommend that the treatment and foll ow-up strategies for patients with ovarian carcinoma be adopted in the mana gement of patients with fallopian tube carcinoma. (C) 2000 American Cancer Society.