How is fallopian tube carcinoma treated?

Updated: Aug 20, 2019
  • Author: from Memorial Sloan-Kettering - Elizabeth L Jewell, MD, MHSc; Chief Editor: from Memorial Sloan-Kettering - Yukio Sonoda, MD  more...
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Answer

Answer

Fallopian tube carcinomas were once believed to be rare. However, investigators have demonstrated precursor cancerous lesions in the fallopian tube (tubal in-situ carcinoma [TIC]) and have provided evolutionary evidence that many advanced serous ovarian cancers originate in the fallopian tubes. [1, 2] Currently, both early-stage and advanced-stage fallopian tube cancers are treated in much the same way as ovarian cancers—that is, with surgery followed by chemotherapy. [3]

Surgery is the initial therapy for stage I-IV fallopian tube cancers. Only a small percentage of women with epithelial fallopian tube cancers are treated with surgery alone. In fact, most patients with stage I disease are treated with adjuvant chemotherapy because of the luminal structure of the organ and the risk of shedding cells out of the tubes and into the abdominal cavity.

The goals of surgical intervention include both staging and tumor debulking. Staging fallopian tube cancer involves the removal of both fallopian tubes and of the ovaries, uterus, cervix, infracolic omentum, and retroperitoneal lymph nodes, in addition to peritoneal washings and peritoneal biopsies.

The data regarding the treatment of fallopian tube cancers are limited and extrapolated from the ovarian cancer literature; no randomized trials have specifically addressed fallopian tube cancers. Accordingly, the chemotherapy used to treat primary fallopian tube cancers is based on the standard management of ovarian cancers.

Consensus-based guidelines from the National Comprehensive Cancer Network (NCCN) suggest administering three to six cycles of chemotherapy for stage IA-IC disease and six to eight cycles for stage II-IV disease. [4] Many physicians feel that administering six cycles of treatment is more appropriate in this disease. As in ovarian cancer, the use of intraperitoneal (IP) chemotherapy must be considered the current standard treatment option in patients with stage II-IV disease.


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