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PubMed1978

Squamous cell carcinoma in situ of the endometrium and fallopian tube as superficial extension of invasive cervical carcinoma.

Five cases of squamous cell carcinoma of the cervix associated with widespread squamous cell carcinoma in situ of the endometrial surface are reported. In one case, carcinoma in situ was also found in one fallopian tube in continuity with the cervicoendometrial lesion. A survey of the literature reveals only 20 cases with similar surface endometrial involvement by cervical squamous cell carcinoma. Of these, the fallopian tubes were involved by an identical lesion in six cases only. Pyometra and cervical stenosis were reported in about 66% of the cases. This rare form of upward cervical cancer extension was present in five of 680 cases (0.7%) of squamous cell carcinoma of the cervix in the file of the Tumor Registry of Magee-Womens Hospital.

Adult↗
PubMed1981

High-risk factors in gynecologic cancer.

Cervical cancer retains its character as a venereal disease associated with infections and multiple sexual partners, but poverty also is important. Precise incidence figures for cervical and endometrial cancer are almost nonexistent because in areas with precise case counts there is rarely accurate knowledge of hysterectomy prevalence. For endometrial cancer little recent attention has been paid to any risk factor except exogenous estrogen. It is now suggested that a low pregnancy rate is a cause, not a consequence, of ovarian pathology leading to cancer. Some progress has been made in separating the epidemiologies of various kinds of ovarian and uterine cancer. A few clues are available regarding the epidemiology of fallopian tube cancers and vaginal cancers other than those produced by maternal stilbestrol. Vulvar cancer becomes common only after the age of 75 and so has been neglected epidemiologically.

Adenocarcinoma↗
PubMed1981

Definition of precursors in gynecologic cancer.

Epithelial lesions of the vulva with patterns of dysplasia or carcinoma in situ may be associated with underlying invasive squamous cell carcinoma or the presence of dysplasia or carcinoma elsewhere on the vulva. These lesions may regress spontaneously, particularly when they appear as multiple papules in young patients. Two major classifications of precancerous lesions of the cervix are in current usage: 1) mild to severe dysplasia and carcinoma in situ; 2) cervical intraepithelial neoplasia, grades I to III. Both of them imply a more complete understanding of the nature of these changes than exists at the present time. Precancerous lesions of the cervix, vagina, vulva, and/or perineum are often associated synchronously or asynchronously. Although there are numerous designations for precancerous lesions of the endometrium, relatively little precise information exists about their significance. In managing women with these lesions, the gynecologist should communicate with the pathologist about the meaning of his diagnostic term, inquiring how far along the road toward invasive carcinoma the precancerous process is judged to be.

Fallopian Tube Neoplasms↗
PubMed1984

The management of primary carcinoma of the fallopian tube. Experience of 40 cases.

Forty patients with primary tubal cancer were treated at the Middlesex and Mount Vernon Hospitals between 1951 and 1981. Actuarial 5-year survival was seen in 68% of 10 Stage I cases, 39% of 17 Stage II cases, and 21% of 11 Stage III cases, and this experience is consistent with other reported postwar series. The disease was found to exhibit some similarity to ovarian cancer in terms of its mode of spread and response to radiation and cytotoxic agents. Transcoelomic spread was identified as the major cause of treatment failure, and management proposals have been structured around its detection and treatment.

Adult↗
PubMed1986

Carcinoma of the fallopian tube. Management and sites of failure.

Thirty patients with adenocarcinoma of the fallopian tube, treated between 1950 and 1981, were studied. Median age was 55 years, and mean parity was 1.3. Bleeding or discharge occurred as a presenting complaint in 47% of patients, abdominal distention or mass in 50%, and pain in 30%. Lesions were staged using a system analogous to the International Federation of Gynecology and Obstetrics (FIGO) classification for ovarian carcinoma. Nine patients had Stage I disease; 11, Stage II; 7, Stage III; and 3, Stage IV. Histologic differentiation was Grade 1 in 39% of the patients, Grade 2 in 18%, and Grade 3 in 43%. Primary surgical treatment consisted of total abdominal hysterectomy and bilateral salpingectomy in 70% of the patients; 23% had more extensive surgery, whereas 13% had less extensive surgery. Three patients with Stage I tumors were treated with surgery alone, and the remainder received postoperative radiation, chemotherapy, or both. Survival was unrelated to grade, but highly dependent upon stage. Survival at 5 years was 56% for Stage I, 27% for Stage II, 14% for Stage III, and 0% for Stage IV. Four of five patients treated after surgery with a combination of cisplatin, doxorubicin, and cyclophosphamide (PAC) survived at least 3 years. Patterns of initial treatment failure showed 56% with a component of pelvic failure, 50% with a component of upper abdominal failure, and 44% with extraperitoneal metastases as a component of failure. These results suggest the need for aggressive postoperative adjuvant therapy targeted at upper abdominal and distant sites for metastasis in all lesions beyond Stage I.

Adult↗
PubMed1989

Results of chemotherapy in advanced carcinoma of the fallopian tube.

Forty-six patients with measurable disease received chemotherapy for advanced primary or recurrent carcinoma of the fallopian tube. The response rate was 9% with single-agent therapy, 29% with multiagent therapy without cisplatin, and 81% with cisplatin-containing combination therapy. Survival was significantly improved in Stage III/IV with the addition of cisplatin-based combination therapy.

Adult↗
PubMed1989

Successful in vitro fertilization and embryo transfer after limited surgical treatment for tubal adenocarcinoma.

A 29-year-old woman with tubal adenocarcinoma stage IA was treated only with bilateral salpingectomy, pelvic lymphadenectomy, and omentectomy. Two years later the patient successfully underwent in vitro fertilization and embryo transfer, and at 39 weeks gave birth to a healthy son by cesarean section. The result of oncologic follow-up 3 years after surgery is negative.

Adenocarcinoma↗
PubMed1990

Fallopian tube cancer. The Roswell Park experience.

Sixty-four patients with primary fallopian tube cancer treated at Roswell Park Memorial Institute from 1964 to 1987 underwent retrospective clinicopathologic review. In 40 patients fallopian tube cancer was the only primary, but in 24 patients primary fallopian tube cancer was part of a multifocal upper genital tract malignancy. Of the 40 patients with unifocal fallopian disease, the median survival was 28 months. Only 15% of patients were alive and disease free with follow-up ranging from 22 to 141 months (median, 90.5 months). Survival was not associated with stage of disease, tumor histology, grade, or depth of invasion in this series. Fourteen patients who received cisplatin-based chemotherapy were evaluable for response. Three patients (21%) responded; two complete and one partial. Twelve patients without clinical evidence of disease underwent second-look procedures, ten laparotomy and two laparoscopy. Four of ten second-look laparotomies were negative. Secondary debulking was done in three of four patients with gross disease, one of which had a negative third-look laparotomy. Negative laparotomy, second-look or third-look, was associated with improved survival (P = 0.016). One of the two laparoscopies was negative, but the patient recurred. In the remaining 24 patients cancer of the fallopian tube was part of a multifocal upper genital tract malignancy. In 12 patients tubal disease was invasive, and in 12, it was in situ. Separate primaries occurred in the ovaries (n = 20); uterus (n = 7); and cervix (n = 2). This represents 1.3% of ovarian malignancies treated at Roswell Park Memorial Institute during the study period. Fallopian tube cancer seems as virulent as ovarian cancer with few long-term survivors. It is frequently associated with other sites of upper genital tract malignancy. Second-look laparotomy is an important predictor of survival. Second-look laparoscopy may be useful if positive.

Adenocarcinoma↗
PubMed1993

Malignant mixed müllerian tumor of the fallopian tube.

BACKGROUND: Malignant mixed müllerian tumor (MMT) of tubal origin is rare and optimal therapy is unknown. METHODS: Five new cases of MMT of the fallopian tube are presented, and the previous literature is reviewed. RESULTS: Eight of 10 patients disease-free at 36 months had long-term cancer-free survival. Surgery alone was inadequate therapy even for those with apparent Stage I disease. Five of six treated postoperatively with radiation and chemotherapy have lived disease-free for at least 45 months. CONCLUSIONS: Combination radiation and chemotherapy may offer improved outcome.

Adult↗
PubMed1993

Transitional cell carcinoma pattern in primary carcinoma of the fallopian tube.

BACKGROUND: A broad papillary proliferation resembling that in transitional cell carcinoma (TCC) of the urinary bladder was seen in 12 of 21 primary carcinomas of the Fallopian tube (PCFT). METHODS: According to their predominant histologic pattern (more than 50%), PCFT were classified into 9 TCC-predominant and 12 non-TCC-predominant tumors. The two groups were compared by clinicopathologic, histochemical, and immunohistochemical means. RESULTS: TCC-predominant tumors were grossly solid and microscopically demonstrated more frequent tumor necrosis and spindled tumor cells than non-TCC-predominant tumors. Mucin histochemistry revealed a correlation between TCC-predominant tumor and sulfomucin-predominant secretion and between non-TCC-predominant tumor and sialomucin-predominant secretion. Immunohistochemical studies for cytokeratins, vimentin, epithelial membrane antigen (EMA), Leu-M1, carcinoembryonic antigen (CEA), and CA 125 were not useful for discrimination between the two groups. Both groups showed similar features in patient age, clinical stage, cytology of ascites or peritoneal washing, and serum CA 125 level. Despite the similarity in treatment (surgery and postoperative chemotherapy) between the two groups, TCC-predominant tumors tended to relapse later (mean, 31.2 months after diagnosis) than non-TCC-predominant tumors (mean, 14.4 months after diagnosis), resulting in a significant difference in the 2-year disease-free survival rate. CONCLUSIONS: TCC pattern and non-TCC pattern are considered to be worthy of distinction in PCFT.

Adult↗
PubMed1994

Laparoscopic infrarenal paraaortic lymph node dissection for restaging of carcinoma of the ovary or fallopian tube.

BACKGROUND: The purpose of the study was to investigate the feasibility of laparoscopic paraaortic lymphadenectomy in the restaging of ovarian carcinomas. METHODS: Nine patients in a referral center seen initially with ovarian (eight patients) or tubal (one patient) carcinoma who had experienced substandard staging during a previous laparotomy or laparoscopy underwent laparoscopic paraaortic lymphadenectomy as part of a surgical staging procedure that included peritoneal fluid sampling and multiple staging biopsies. Omentectomy, appendectomy, pelvic lymphadenectomy, contralateral salpingo-oophorectomy, salpingectomy, or laparoscopically assisted total vaginal hysterectomy was performed during the same operative session when necessary. RESULTS: All nine lymphadenectomies up to the level of the renal veins were successfully completed. The postoperative periods were uneventful, with an average postoperative stay of 2.8 days. CONCLUSIONS: Laparoscopic surgery may be an acceptable procedure for paraaortic lymph node sampling, sparing the patient a restaging laparotomy.

Adult↗
PubMed1995

c-erbB-2 and p53 expression in fallopian tube carcinoma.

BACKGROUND: Carcinoma of the fallopian tube is a rare gynecologic malignancy. Its histologic appearance and patterns of spread are similar to those of epithelial ovarian cancer. Alterations in the gene products of c-erbB-2 (HER-2/neu) and p53 are found commonly in ovarian tumors and may have prognostic relevance. The authors sought to determine whether tubal cancers are biologically similar to ovarian cancer with respect to the expression of these two molecular markers. METHODS: A cohort of 43 patients with fallopian tube cancer was studied. Immunohistochemical staining for c-erbB-2 and p53 was performed on pretreatment tissue blocks. Clinical information was available for all patients, with a median follow-up of 9 years. Clinicopathologic correlations were made. RESULTS: Nine patients had Stage I disease, 11 had Stage II disease, 18 had Stage III disease, and 5 had Stage IV disease, with a median survival was 65 months. c-erbB-2 overexpression was found in 11 cases (25.6%), and p53 positivity was noted in 26 cases (60.5%). Log rank survival curves showed no association between staining for c-erbB-2 or p53 expression and clinical outcome. A multivariate analysis identified patient age older than 65 years (P = 0.05) and Stage III or IV disease (P = 0.0065) as the only variables that predicted poor outcome. CONCLUSIONS: Fallopian tube cancers are similar to ovarian cancer with respect to the proportion of tumors with abnormal expression of c-erbB-2 and p53. The authors could not demonstrate that these two molecular markers had prognostic relevance in this disease, but the size of their cohort was limited. However, the potential prognostic relevance of c-erbB-2 and p53 expression in tubal cancers should be pursued in a larger cohort.

Age Factors↗
PubMed1995

High incidence of point mutation in K-ras codon 12 in carcinoma of the fallopian tube.

BACKGROUND: Adenocarcinoma of the fallopian tube is a rare tumor with a poor prognosis. Whether these carcinomas possess any genetic changes that contribute to their malignant behavior is unknown and to date few studies regarding the molecular pathogenesis of these tumors have been reported. In adenocarcinoma of the endometrium, mutations in the first exon of K-ras, although relatively infrequent, were observed to be an independent risk factor for poor clinical outcome. METHODS: Eight patients with adenocarcinoma of the fallopian tube were examined for mutations in the 12th codon of K-ras. DNA was obtained from single sections of paraffin embedded tumor tissue and the first exon of K-ras was amplified by the polymerase chain reaction. Point mutations were assayed using a nonradioactive restriction fragment length polymorphism technique. RESULTS: The eight patients in this study varied in clinical stage from I-IV and were all treated with surgery and chemotherapy. Six of eight of the patients died and one of the surviving patients had metastases in the vertebrae. K-ras point mutations were detected at codon 12 in seven of the eight tumors (87.5%). CONCLUSIONS: K-ras mutations occurred with high frequency in this series of eight patients with fallopian tube carcinoma, suggesting that mutations of this protooncogene could play an important role in the molecular pathogenesis of this lesion.

Adenocarcinoma↗