A 10 Year Review of Primary Fallopian Tube Carcinoma (PFTC) at an Oncology Hospital. A Clinicopathological Study of 58 Cases with Evaluation of Staging and Prognostic Factors
I Alvarado-Cabrero, G Picon-Coronel, FO Quijano-Castro. Mexican Oncology Hospital, Mexico, DF, Mexico
Background: PFTC represents only 0.3-1.9% of all gynecological tumors, this relative low number of patients do not permit any conclusive statement with regard to the prognostic value of factors affecting PFTC. On the other hand, the current staging system of the FIGO for PFTC does not consider two subsets of tubal carcinoma: non-invasive intraluminal carcinoma and carcinoma confined to the fimbriated end of the tube. To accommodate those subsets of tumors, a modification of the FIGO staging system was proposed by Alvarado-Cabrero et al (Gyn Oncol, 1999). The goals of this study were to assess the association between the “modified staging system” (mss) and survival and stage and carcinoma subtype.
Design: Patients diagnosed with PFTC between 1999-2009 were identified from the files of our Institution. Clinical and follow-up information was retrieved from patient´s (pts) charts. The tumors were staged in accordance with the mss. Tumor grade according with the FIGO-grading system and carcinoma subtype were also recorded. Statistical comparison was made using the chi-square test or Fisher´s Exact test.
Results: Pts ranged in age from 46 to 89 years (median:62): The most common complaints were abnormal vaginal bleeding and abdominal pain (> 80%). The symptom complex of hidrops tubae profluens was found in 8(13.7%) pts. Fourteen(24%) pts also had breast cancer. The PFTC were staged as follows: Stage IA-0:9, Stage IA-1:8, Stage IA-2:11, Stage IB-0:2, Stage IC: 20, Stage IF:2, Stage II: 2, Stage III: 2, and Stage IV: 2. There was a statistically significant difference in length of survival between pts with Stage I(A,B) -0 and 1 and those with Stage IA-2 tumors, 96.5 months vs 60.2 months, respectively (P: 0.006). The cell types were as follows: serous 41%, endometrioid 31%, transitional 10%, clear cell 8.6% and mucinous 5%. Only 2 carcinomas were undifferentiated and they were limited to the fimbrial end of the tube. Most serous carcinomas (85%) were associated with stage IC or higher, high grade and poor outcome. In contrast, 78.5% of patients with endometrioid carcinoma were low grade and associated with Stage I (A,B)-0 and 1 and with prolonged survival. (P:<0.0001)
Conclusions: Substaging Stage IA tumors into IA-1 and IA-2 indicates a decreasing survival with increasing depth of invasion Serous Carcinomas of the fallopian tube are associated with high grade, higher stage of the disease and poor prognosis.
Category: Gynecologic & Obstetrics
Tuesday, March 23, 2010 8:30 AM
Platform Session: Section D, Tuesday Morning