Radiation Oncology/Fallopian tube

Staging

AJCC 7th Edition (2009)

Primary Tumor: (FIGO stage in parentheses)

• T1 (I) - limited to the fallopian tubes
  • T1a (IA) - limited to one tube, without penetrating the serosal surface; no ascites
  • T1b (IB) - limited to both tubes, without penetrating the serosal surface; no ascites
  • T1c (IC) - limited to one or both tubes with extension onto or through the tubal serosa; or with malignant cells in ascites or washings
• T2 (II) - pelvic extension
  • T2a (IIA) - extension and/or metastasis to the uterus and/or ovaries
  • T2b (IIB) - extension to other pelvic structures
  • T2c (IIC) - pelvic extension with malignant cells in ascites or washings
• T3 (III) - peritoneal implants outside the pelvis
  • T3a (IIIA) - microscopic peritoneal metastasis outside the pelvis
  • T3b (IIIB) - macroscopic peritoneal metastasis outside the pelvis, 2cm or less
  • T3c (IIIC) - peritoneal metastasis outside the pelvis, more than 2 cm

Regional Lymph Nodes: include pelvic, paraaortic, inguinal

• N0 - no
• N1 (IIIC) - yes

Distant Metastases:

• M0 - no
• M1 (IV) - yes

Stage Grouping:

Follows FIGO stage above (in parentheses). T3c and N1 are both IIIC.

Older staging editions

AJCC 6th Edition (2002)

• No changes compared to 7th edition

Risk Factors

• Harvard; 2007 (1999-2007) PMID 17761984 -- "Primary fallopian tube malignancies in BRCA-positive women undergoing surgery for ovarian cancer risk reduction." (Callahan MJ, J Clin Oncol. 2007 Sep 1;25(25):3985-90.)
  • Retrospective. 122 BRCA+ patients with prophylactic ovarian CA surgery. Median age 46 years
  • Outcome: 6% early malignancy, 100% (n=7) originated in distal fallopian tube, 2 surface implants on the ovary
  • Conclusion: Distal fallopian tube dominant site of origin for BRCA+ women at risk for GYN carcinomas

Retrospective

• PMID 9422560 (1960 - 1995) — "Adenocarcinoma of the fallopian tube: results of a multi-institutional retrospective analysis of 72 patients." Wolfson AH et al. Int J Radiat Oncol Biol Phys. 1998 Jan 1;40(1):71-6.
  • Multicenter. 72 pts.