Fallopian Tube Cancer
Primary fallopian tube cancer (tubal cancer) is rare and accounts for just 1 to 2 percent of all gynecologic cancers. It is more common for cancer to spread (metastasize) from other parts of the body than for cancer to originate in the fallopian tubes.
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MeSH term: Fallopian Tube Neoplasms
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A Phase II clinical trial of pegylated liposomal doxorubicin and carboplatin in Japanese patients with platinum-sensitive recurrent ovarian, fallopian tube or primary peritoneal cancer.
Jpn J Clin Oncol. 2015; 45(5):422-6 [PubMed] Related Publications
METHODS: Patients with a histological diagnosis of epithelial ovarian, fallopian tube or primary peritoneal carcinoma, who were relapse-free at least 6 months after completion of first-line platinum-based chemotherapy, and who had measurable disease and gave consent to participate in this study received infusions of pegylated liposomal doxorubicin (30 mg/m(2)) at 1 mg/min, followed by carboplatin (AUC 5 mg min/ml) over 30 min every 28 days.
RESULTS: Thirty-three of 35 enrolled patients were eligible for efficacy analysis. One patient (3.0%) achieved a complete response, while 16 (48.5%) achieved a partial response, with an overall objective response rate of 51.5% (95% confidence interval, 34.5-68.6%). Among the 22 patients who had evaluable CA125 levels at entry, responses were observed in 18 patients, with a response rate of 81.8% (95% confidence interval, 65.3-98.3%). The median progression-free survival and overall survival rates for all 35 patients were 10.7 months (95% confidence interval, 8.1-13.2 months) and 38.8 months (95% confidence interval, 31.0-46.7 months), respectively. The most frequent Grade 3-4 toxicities, regardless of cause, were neutropenia (82.9%), thrombocytopenia (51.4%), leukopenia (45.7%) and anemia (17.1%).
CONCLUSIONS: The safety and efficacy of pegylated liposomal doxorubicin and carboplatin combination chemotherapy in patients with platinum-sensitive recurrent ovarian cancer were confirmed. Although there were concerns of severe hematological toxicity with this therapy, this potential complication was safely managed through adequate monitoring of bone marrow function.
Serous ovarian, fallopian tube and primary peritoneal cancers: a common disease or separate entities - a systematic review.
Gynecol Oncol. 2015; 136(3):571-81 [PubMed] Related Publications
METHODS: A systematic literature search was conducted in PubMed and MEDLINE. Case-control studies comparing primary serous peritoneal or fallopian tube carcinomas with primary serous ovarian carcinomas or a control group were included.
RESULTS: Twenty-eight studies were found eligible. Primary peritoneal cancer patients were older, had higher parity, were more often obese and had poorer survival compared to ovarian cancer patients. Differences in protein expression patterns of Her2/neu, estrogen and progestin receptors and frequency of loss of heterozygosity differed between primary peritoneal cancer and primary ovarian cancer patients. No major differences were found between primary fallopian tube cancer and primary ovarian cancer. The proportion of serous tubal intraepithelial carcinomas (STIC) was lower in primary peritoneal cancer and primary ovarian cancer compared to primary fallopian tube cancer.
CONCLUSION: Except from differences in the proportion of STIC only few differences between primary fallopian tube cancer and primary ovarian cancer have been found. In contrast, observed differences in risk factor profile, clinicopathologic and prognostic factors, as well as in the molecular patterns, indicate that peritoneal cancer and ovarian cancer may be linked to different carcinogenic pathways.
Incidental nonuterine high-grade serous carcinomas arise in the fallopian tube in most cases: further evidence for the tubal origin of high-grade serous carcinomas.
Am J Surg Pathol. 2015; 39(3):357-64 [PubMed] Related Publications
Clinical characteristics and outcomes of patients with stage I epithelial ovarian cancer compared with fallopian tube cancer.
Am J Obstet Gynecol. 2015; 212(5):600.e1-8 [PubMed] Related Publications
STUDY DESIGN: We identified women with stage I epithelial ovarian cancer and fallopian tube cancer who underwent treatment from 2000-2010. Correlation between categoric variables was assessed with χ2 test. The Kaplan-Meier survival analysis was used to generate overall survival data. Factors predictive of outcome were compared with the use of the log-rank test and Cox proportional hazards model.
RESULTS: The study group consisted of 385 women with epithelial ovarian cancer and 43 women with fallopian tube cancer. Patients with fallopian tube cancer had a higher rate of stage IA disease (65% vs 48%; P=.02) and grade 3 tumors (60.4% vs 30.9%; P<.001). Patients with fallopian tube cancer had a significantly higher rate of breast cancer (25.6% vs 5.7%; P<.001) and BRCA 1 mutations (45.8% vs 9.1%; P<.001). There was no difference in the rates of platinum-based and paclitaxel chemotherapy between the groups. Women with fallopian tube cancer were more likely to have received ≥6 cycles of chemotherapy (58.1% vs 44.1%; P=.02). The 5-year disease-free survival rates were 100% in women with fallopian tube cancer and 93% in patients with epithelial ovarian cancer (P=.04). The 5-year overall survival rates were 100% and 95% for fallopian tube cancer and epithelial ovarian cancer, respectively (P=.7).
CONCLUSION: We found a higher rate of stage IA, grade 3, and serous carcinoma in fallopian tube cancer. Women with fallopian tube cancer had a higher rate of breast cancer. There was no difference in overall survival between the groups.
A multicenter, non-randomized, phase II study of docetaxel and carboplatin administered every 3 weeks as second line chemotherapy in patients with first relapse of platinum sensitive epithelial ovarian, peritoneal or fallopian tube cancer.
BMC Cancer. 2014; 14:937 [PubMed] Free Access to Full Article Related Publications
METHODS: Patients with stage IC-IV epithelial ovarian, peritoneal or fallopian tube cancer were enrolled at the first relapse after at least 6 months since completion of the first line treatment. Docetaxel 75 mg/m2 was given as an one hour IV infusion followed immediately by carboplatin (AUC=5) given as a 30-60 min. IV infusion on day 1 and repeated every 3 weeks for 6-9 courses. Primary endpoint was toxicity; secondary endpoints were response rate and the time to progression.
RESULTS: A total of 74 patients were included. Of these, 50 patients received 6 or more cycles, 13 received 3-5 courses and 11 received less than 3 courses. A total of 398 cycles were given. Grade 3/4 neutropenia was seen in 80% (59 of 74) patients with an incidence of febrile neutropenia of 16%. Grade 2/3 sensory peripheral neuropathy occurred in 7% of patients, but no grade 4 sensory peripheral neuropathy was observed. Sixty patients were evaluable for response. The overall response rate was 70% with 28% complete responses in the response evaluable patient population. Median progression-free survival was 12.4 months (95% CI 10.4-14.4).
CONCLUSIONS: The three-weekly regimen of docetaxel in combination with carboplatin was feasible and active as second-line treatment of platinum-sensitive ovarian, peritoneal and Fallopian tube cancer. The major toxicity was neutropenia, while the frequency of peripheral neuropathy was low.
Primary fallopian tube carcinoma: a case report.
Pan Afr Med J. 2014; 18:263 [PubMed] Free Access to Full Article Related Publications
Primary choriocarcinoma of the fallopian tube: a case report and literature review.
Eur J Gynaecol Oncol. 2014; 35(5):604-7 [PubMed] Related Publications
Primary fallopian tube carcinoma: a case report and mini-review of the literature.
Eur J Gynaecol Oncol. 2014; 35(5):595-6 [PubMed] Related Publications
Preoperative diagnosis of fallopian tube malignancy with transvaginal color doppler ultrasonography and magnetic resonance imaging after negative hysteroscopy for postmenopausal bleeding.
Coll Antropol. 2014; 38(3):1047-50 [PubMed] Related Publications
Primary fallopian tube carcinoma: correlation between magnetic resonance and diffuse weighted imaging characteristics and histopathologic findings.
J Comput Assist Tomogr. 2015 Mar-Apr; 39(2):270-5 [PubMed] Related Publications
METHODS: The clinical, MR, and DW imaging characteristics and pathologic findings of 23 patients with 27 tumors were studied retrospectively. The MR and DW imaging appearance of tumors including laterality, size and shape, architecture, signal intensity, apparent diffusion coefficient (ADC) value, enhancement pattern, hydrosalpinx, and intrauterine fluid collection were evaluated and correlated with pathologic findings.
RESULTS: Histopathologically, all 27 tumors were serous carcinoma with a unilateral tumor in 19 patients and bilateral tumors in 4 patients. Thirteen patients (57%) with PFTC were misdiagnosed preoperatively, 10 of which as epithelial ovarian carcinoma. The mean (SD) largest diameter was 61 (7) mm. The tumor shape was fusiform, sausagelike, or serpentine in 19 patients (70%) and nodular or irregular in 8 patients (30%). Twenty (74%) of the 27 tumors were solid, and 7 (26%) were cystic-solid. The solid components showed hypointensity to isointensity on T1-weighted imaging, and isointensity to slight hyperintensity on T2-weighted imaging. There were obvious hyperintensity on DW imaging; obvious hypointensity on ADC maps with a mean (SD) ADC value of 0.79 (0.22) × 10 mm; and mild (8/27, 30%), moderate (13/27, 48%), and marked (6/27, 22%) enhancement on contrast-enhanced imaging. Ipsilateral hydrosalpinx, intrauterine fluid collection, and ascites were found in 14 tumors (52%) and 7 (30%) and 5 (22%) patients, respectively.
CONCLUSIONS: The PFTC has some characteristic MR imaging features. The DW imaging, ADC maps, and ADC values are helpful for the detection and differentiation of PFTC from other pelvic masses.
Clinical and survival analysis of 36 cases of primary fallopian tube carcinoma.
World J Surg Oncol. 2014; 12:311 [PubMed] Free Access to Full Article Related Publications
METHODS: A total of 36 patients for whom PFTC was pathologically confirmed from January 2001 to July 2011 in Beijing Hospital of Gynecology and Obstetrics, an affiliate of Capital Medical University, were retrospectively analyzed.
RESULTS: A total of 36 cases underwent surgical staging in our hospital: 47.2% were early stage cases , and 52.8% were advanced stage cases. Of the 36 cases, 24 cases were pure adenocarcinoma, 10 cases were mixed, and there was 1 case of undifferentiated carcinoma, 1 case of undifferentiated carcinoma combined with transitional cell carcinoma, 5 cases of moderately differentiated carcinoma, and 29 cases of moderately to poorly differentiated carcinoma. There were no cases of highly differentiated carcinoma. Among the cases examined, 38.9% (14/36) had omentum metastasis, and 19 cases had an elevated CA125 during a preoperative biochemical laboratory test. Approximately 35 cases received postoperative adjuvant chemotherapy. The 3-year and 5-year overall survival rates for the 36 cases were 80.7% and 65.4%, respectively. Single-factor analysis showed that the pathological conditions of residual tumor diameter >1 cm (P < 0.001), omentum metastasis (P = 0.003), ovary metastasis (P = 0.004) and elevated preoperative CA125 (P = 0.044) were associated with prognosis, whereas pathological surgical staging (P = 0.069), retroperitoneal lymph node metastasis (P = 0.499), and pathological classification (P = 0.183) were not associated with prognosis. Multifactor analysis showed that a residual tumor diameter >1 cm (P = 0.019) and omentum metastasis (P = 0.015) were associated with prognosis, and were, therefore, the independent risk factors of prognosis.
CONCLUSIONS: PFTC is a rare female genital tract malignancy. Most patients are in an advanced stage at diagnosis, which results in a poor prognosis. Complete surgical staging and maximal resection should be recommended.
Primary fallopian tube cancer: domestic data and up-to-date review.
Taiwan J Obstet Gynecol. 2014; 53(3):287-92 [PubMed] Related Publications
Primary serous papillary adenocarcinoma of the fallopian tube.
Acta Clin Croat. 2014; 53(2):242-5 [PubMed] Related Publications
Evaluation of the fallopian tubes after neoadjuvant chemotherapy: persistence of serous tubal intraepithelial carcinoma.
Int J Gynecol Pathol. 2014; 33(5):463-9 [PubMed] Related Publications
The new FIGO staging system for ovarian, fallopian tube, and primary peritoneal cancer.
Arch Gynecol Obstet. 2014; 290(5):839-42 [PubMed] Related Publications
MATERIAL AND METHODS: The recent publication of Jaime Prat describing the new FIGO classification is summarized. The major changes compared to the hitherto existing classification from 1988 are presented.
RESULTS: The primary anatomy is now documented (ov for ovarian, ft for fallopian tube, p for peritoneal, X for not assessed). The histological subtype is also documented (HGSC for high-grade serous carcinoma, LGSC for low-grade serous carcinoma, MC for mucinous carcinoma, CCC for clear cell carcinoma, and EC for endometrioid carcinoma). There is no stage I peritoneal cancer. Stage IC is subdivided into intraoperative rupture (IC1), pre-operative rupture (IC2), and malignant ascites or peritoneal washings (IC3). Due to its anatomic position within the pelvis, metastasis to the sigmoid colon is considered stage II. Former stage IIC has been erased. Stage IIIA1 and IIIA2 have been defined for intra-pelvic tumor with metastasis to retro-peritoneal lymph nodes up to 1 cm (IIIA1) or larger than 1 cm (IIIA2). With this, some of the former stage IIIC cases become IIIA and some IIIB, respectively. Involvement of retroperitoneal lymph nodes must be proven cytologically or histologically. Stage IV has been subdivided into IVA (malignant pleural effusions) and IVB (parenchymal metastases and/or extra-abdominal metastases including tumors in inguinal lymph nodes or lymph nodes outside of the abdominal cavity, umbilical tumor deposit, and transmural bowel infiltration (with mucosal involvement).
CONCLUSION: The new FIGO classification takes into account the recent findings on the origin, pathogenesis, and prognosis of different ovarian cancer subtypes, summarizes groups of tumors pragmatically, and implies a reproducible and stage-dependent therapeutical approach.
A randomised, placebo-controlled trial of weekly paclitaxel and saracatinib (AZD0530) in platinum-resistant ovarian, fallopian tube or primary peritoneal cancer†.
Ann Oncol. 2014; 25(10):1988-95 [PubMed] Related Publications
PATIENTS AND METHODS: Patients with platinum-resistant ovarian, fallopian tube or primary peritoneal cancer were randomised 2 : 1 to receive 8-week cycles of weekly paclitaxel (wPxl; 80 mg/m(2)/week ×6 with 2-week break) plus saracatinib (S; 175 mg o.d.) or placebo (P) continuously, starting 1 week before wPxl, until disease progression. Patients were stratified by taxane-free interval (<6 versus ≥6 months/no prior taxane). The primary end point was progression-free survival (PFS) rate at 6 months. Secondary end points included overall survival (OS) and response rate (RR).
RESULTS: A total of 107 patients, median age 63 years, were randomised. Forty-three (40%) had received >2 lines of prior chemotherapy. The 6-month PFS rate was 29% (wPxl + S) versus 34% (wPxl + P) (P = 0.582). Median PFS was 4.7 versus 5.3 months (hazard ratio 1.00, 95% confidence interval 0.65-1.54; P = 0.99). RR (complete + partial) was 29% (wPxl + S) versus 43% (wPxl + P), P value = 0.158. Grade 3/4 adverse events were 36% versus 31% (P = 0.624); the most frequent G3/4 toxicities were vomiting (5.8% saracatinib versus 8.6% placebo), abdominal pain (5.8% versus 0%) and diarrhoea (4.3% versus 5.7%). Febrile neutropenia was more common in the saracatinib arm (4.3%) than placebo (0%). Response, PFS and OS were all significantly (P < 0.05) better in patients with taxane interval ≥6 months/no prior taxane (n = 85) than those <6 months (n = 22), regardless of randomisation.
CONCLUSIONS: Saracatinib does not improve activity of weekly paclitaxel in platinum-resistant ovarian cancer. Taxane-free interval of ≥6 months/no prior taxane was associated with better outcome in both groups.
TRIALS REGISTRATION: Clinicaltrials.gov NCT01196741; ISRCTN 32163062.
A cautious view of putative precursors of serous carcinomas in the fallopian tubes of BRCA mutation carriers.
Gynecol Oncol. 2014; 134(3):492-7 [PubMed] Related Publications
METHODS: 78 BRCA carriers (52 BRCA1, 26 BRCA2) and 23 controls underwent RRSO. Fallopian tubes were serially cross-sectioned, and adnexa were entirely submitted and examined by two gynecologic pathologists blinded to BRCA mutation status. The presence and location of serous tubal intraepithelial carcinoma (STIC), p53 overexpression (≥ 6 consecutively stained nuclei), Ki67 overexpression, atypia/low grade dysplasia and epithelial hyperplasia were compared between BRCA carriers and controls. Patient age was dichotomized: ≤ 50 and >50 years.
RESULTS: 9 (12%) BRCA carriers had occult carcinoma: 8 STIC and 1 stage IC tubal carcinoma with STIC. No occult carcinomas or STIC was seen in controls. STIC involved the distal tube in all cases and was multifocal in three cases. STIC was more common in women >50 (p=0.06). P53 overexpression was common in BRCA carriers (30%) and controls (43%) (p=0.5) and did not correlate with age. Only 5/9 (55%) of STIC exhibited p53 overexpression. 2 patients had Ki67 overexpression: both BRCA1 carriers with STIC. No difference in the frequency of atypia/low grade dysplasia or hyperplasia was observed between BRCA carriers and controls.
CONCLUSIONS: STIC is the dominant precursor of serous fallopian tube carcinoma in BRCA carriers. There is insufficient evidence to support p53 overexpression alone as a putative precursor. Atypia/low grade dysplasia and epithelial hyperplasia are not pre-neoplastic lesions of serous fallopian tube carcinoma.
Nongynecologic metastases to fallopian tube mucosa: a potential mimic of tubal high-grade serous carcinoma and benign tubal mucinous metaplasia or nonmucinous hyperplasia.
Am J Surg Pathol. 2015; 39(1):35-51 [PubMed] Related Publications
An unusual case of cavernous haemangioma of the Fallopian tube.
J Cancer Res Ther. 2014 Apr-Jun; 10(2):363-4 [PubMed] Related Publications
A multicenter prospective trial evaluating the ability of preoperative computed tomography scan and serum CA-125 to predict suboptimal cytoreduction at primary debulking surgery for advanced ovarian, fallopian tube, and peritoneal cancer.
Gynecol Oncol. 2014; 134(3):455-61 [PubMed] Article available free on PMC after 01/09/2015 Related Publications
METHODS: This was a prospective, non-randomized, multicenter trial of patients who underwent primary cytoreduction for stage III-IV ovarian, fallopian tube, and peritoneal cancer. A CT scan of the abdomen/pelvis and serum CA-125 were obtained within 35 and 14 days before surgery, respectively. Four clinical and 20 radiologic criteria were assessed.
RESULTS: From 7/2001 to 12/2012, 669 patients were enrolled; 350 met eligibility criteria. The optimal debulking rate was 75%. On multivariate analysis, three clinical and six radiologic criteria were significantly associated with suboptimal debulking: age ≥ 60 years (p=0.01); CA-125 ≥ 500 U/mL (p<0.001); ASA 3-4 (p<0.001); suprarenal retroperitoneal lymph nodes >1cm (p<0.001); diffuse small bowel adhesions/thickening (p<0.001); and lesions >1cm in the small bowel mesentery (p=0.03), root of the superior mesenteric artery (p=0.003), perisplenic area (p<0.001), and lesser sac (p<0.001). A 'predictive value score' was assigned for each criterion, and the suboptimal debulking rates of patients who had a total score of 0, 1-2, 3-4, 5-6, 7-8, and ≥ 9 were 5%, 10%, 17%, 34%, 52%, and 74%, respectively. A prognostic model combining these nine factors had a predictive accuracy of 0.758.
CONCLUSIONS: We identified nine criteria associated with suboptimal cytoreduction, and developed a predictive model in which the suboptimal rate was directly proportional to a predictive value score. These results may be helpful in pretreatment patient assessment.
A phase II study of ramucirumab (IMC-1121B) in the treatment of persistent or recurrent epithelial ovarian, fallopian tube or primary peritoneal carcinoma.
Gynecol Oncol. 2014; 134(3):478-85 [PubMed] Related Publications
METHODS: Women who received ≥ 1 platinum-based chemotherapeutic regimen and had a platinum-free interval of <12 months with measurable disease were eligible. Patients received 8 mg/kg ramucirumab intravenously every 2 weeks.
RESULTS: Sixty patients were treated; one patient remained on study as of September 2013. The median age was 62 years (range: 27-80), and median number of prior regimens was 3. Forty-five (75%) patients had platinum refractory/resistant disease. Thirty-nine patients (65.0%) had serous tumors. PFS-6 was 25.0% (n=15/60, 95% CI: 14.7-37.9%). Best overall response was: partial response 5.0% (n=3/60), stable disease 56.7% (n=34/60), and progressive disease 33.3% (n=20/60). The most common treatment-emergent adverse events possibly related to study drug were headache (65.0%; 10.0% Grade ≥ 3), fatigue (56.7%; 3.3% Grade ≥ 3), diarrhea (28.3%; 1.7% Grade ≥ 3), hypertension (25.0%; 3.3% Grade ≥ 3), and nausea (20.0%; no Grade ≥ 3). Two patients experienced intestinal perforations (3.3% Grade ≥ 3). Pharmacodynamic analyses revealed changes in several circulating VEGF proteins following initial ramucirumab infusion, including increased VEGF-A, PlGF and decreased sVEGFR-2.
CONCLUSIONS: Although antitumor activity was observed, the predetermined efficacy endpoints were not met.
Prognostic factors of primary fallopian tube cancer in a single institute in Taiwan.
Int J Gynaecol Obstet. 2014; 127(1):77-81 [PubMed] Related Publications
METHODS: A retrospective review of the database of a tertiary hospital in Taiwan for 1978-2007 was conducted to identify patients with a diagnosis of PFTC and to evaluate the clinicopathologic features associated with PFTC outcome.
RESULTS: Fifty-eight patients (mean age 62.5 years) had a diagnosis of PFTC. Stage III/IV disease (55%) and poorly differentiated tumors (52%) were most common. The median follow-up was 93 months (range, 11-333 months). The 5-year disease-free survival rate was 59%, and the overall survival rate was 64%. Factors important in disease-free and overall survival in univariate analysis included the presence of pelvic and/or para-aortic lymph node metastases, International Federation of Gynecology and Obstetrics stage, high preoperative carbohydrate antigen 125 serum level, completion of optimal debulking surgery, and the use of paclitaxel-based chemotherapy; however, only patients with optimal cytoreduction had a decreased hazard of recurrence (hazard ratio [HR] 0.06; 95% confidence interval [CI] 0.01-0.23) and mortality (HR 0.08; 95% CI, 0.02-0.31) in multivariate analysis.
CONCLUSION: Advanced tumor stage, in particular the presence of lymph node metastases, worsened the prognosis of patients with PFTC. However, optimal debulking surgery significantly improved the prognosis, emphasizing the importance of the treatment strategy.
Recurrence patterns of advanced ovarian, fallopian tube, and peritoneal cancers after complete cytoreduction during interval debulking surgery.
Int J Gynecol Cancer. 2014; 24(6):991-6 [PubMed] Related Publications
METHODS: We retrospectively reviewed data of patients with stage III or IV ovarian, fallopian tube, and peritoneal cancers who were treated at our hospital from January 1, 2005, to December 31, 2011.
RESULTS: In this study, 105 patients underwent neoadjuvant chemotherapy followed by IDS and achieved complete cytoreduction. The median follow-up period was 42.1 months. Recurrence was documented in 70 patients (66.7%), and 35 (33.3%) showed no evidence of disease. Peritoneal dissemination was the most common recurrence (60.0%) observed. In multivariate analysis, positive peritoneal cytology (P = 0.0003) and elevated pre-IDS serum CA125 levels (P = 0.046) were independent risk factors for recurrence.
CONCLUSIONS: After complete cytoreduction during IDS in patients with stage III or IV ovarian, fallopian tube, and peritoneal cancers, positive peritoneal cytology at IDS and elevated pre-IDS CA125 levels are associated with an increased risk of cancer recurrence. Positive peritoneal cytology during IDS is a particularly strong predictive factor for poor outcomes in these patients.
Fallopian tube high-grade serous carcinoma with intramucosal spread and presenting as a malignancy on pap smear.
Int J Gynecol Pathol. 2014; 33(4):443-8 [PubMed] Related Publications
A small organ takes center stage: selected topics in fallopian tube pathology.
Int J Gynecol Pathol. 2014; 33(4):385-92 [PubMed] Related Publications
Early detection of high-grade tubal serous carcinoma in women at low risk for hereditary breast and ovarian cancer syndrome by systematic examination of fallopian tubes incidentally removed during benign surgery.
Am J Surg Pathol. 2014; 38(6):729-42 [PubMed] Related Publications
Survival and prognostic factors of patients with primary fallopian tube cancer receiving adjuvant paclitaxel and carboplatin chemotherapy.
J Obstet Gynaecol Res. 2014; 40(3):806-11 [PubMed] Related Publications
METHODS: The records of patients with PFTC who had been treated between 2002 and 2010, identified through the report of Chiang Mai University Hospital, were reviewed. All patients had pathological materials initially reported or reviewed by a gynecologic pathologist before initiation of treatment.
RESULTS: Thirty patients met the inclusion criteria. Median age was 51 years. Serous adenocarcinoma was observed in the majority of patients (76.7%). Approximately 46% of patients were in stage I–II. The 5-year progression-free survival (PFS) for all patients was 37.2%. The 5-year PFS was 75.0% for stage I, 51.4% for stage II and 18.5% for stage III. Median PFS of the entire cohort was 26.0 months with a 95% confidence interval (CI) of 18.7–33.3 months. This rate was 18.5 months (95% CI, 6.7–35.6) for stage III whereas it was not reached for patients of stage I–II. Serous histology and stage were noted to be significant independent predictors of PFS with an adjusted hazards ratio of 7.54 (95% CI, 1.34–42.4) and 6.19 (95% CI, 1.59–24.08), respectively.
CONCLUSION: The 5-year PFS of the whole cohort was 37.2% with a median survival of 26 months. International Federation of Gynecology and Obstetrics stage and histological subtype were a significant independent factor for predicting PFS.
Genomic aberrations of BRCA1-mutated fallopian tube carcinomas.
Am J Pathol. 2014; 184(6):1871-6 [PubMed] Related Publications
Randomised phase II study of docetaxel plus vandetanib versus docetaxel followed by vandetanib in patients with persistent or recurrent epithelial ovarian, fallopian tube or primary peritoneal carcinoma: SWOG S0904.
Eur J Cancer. 2014; 50(9):1638-48 [PubMed] Article available free on PMC after 01/09/2015 Related Publications
METHODS: Women with refractory or progressive OC were randomised 1:1 to docetaxel (75 mg/m(2), IV)+vandetanib (100mg daily, PO, D+V) or docetaxel (75 mg/m(2), D). Up to three additional cytotoxic regimens for recurrence and prior anti-angiogenic agents (as primary therapy) were allowed. The primary end-point was progression free survival (PFS). The study had 84% power to detect a PFS hazard ratio of 0.65, using a one-sided P of 0.1. This corresponds to an increase in median PFS from 3.6 months to 5.6 months. Patients progressing on D were allowed to receive single agent vandetanib (D → V).
RESULTS: 131 Patients were enrolled; two were excluded. 16% had received prior anti-angiogenic therapy. The median PFS estimates were 3.0 mos (D+V) versus 3.5 (D); HR: 0.99 (80% CI: 0.79-1.26). 61 Patients on D+V were assessable for toxicity; 20(33%) had treatment-related Grade (G) 4 events, primarily haematologic. Similarly, 17 (27%) of 64 patients receiving D had G4 events, primarily haematologic. 27 Evaluable patients crossed-over to V. 1/27(4%) experienced a G4 event. G3 diarrhoea was observed in 4% D → V patients. Median OS was 14 mos (D+V) versus 18 mos (D → V); HR(OS): 1.25 (80% CI: 0.93-1.68). Crossover vandetanib response was 4% (1/27 evaluable patients). High plasma IL-8 levels were associated with response to D+V.
CONCLUSIONS: Combination docetaxel+vandetanib did not prolong PFS relative to docetaxel alone in OC patients. No unexpected safety issues were identified.
A phase II trial of intraperitoneal EGEN-001, an IL-12 plasmid formulated with PEG-PEI-cholesterol lipopolymer in the treatment of persistent or recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer: a gynecologic oncology group study.
Gynecol Oncol. 2014; 133(3):433-8 [PubMed] Article available free on PMC after 01/09/2015 Related Publications
METHODS: Eligible patients had weekly IP infusion of EGEN-001 at a dose of 24mg/m(2). Toxicity and antitumor activity were evaluated using CTCAE and RESIST criteria, respectively. Co-primary endpoints were tumor response and survival without progression (PFS) for at least 6months. Survival without progression before going onto a subsequent therapy (EFS) for at least six months was also considered.
RESULTS: A total of 58 EGEN-001 cycles were administered to 20/22 enrolled patients (median 2cycles, range 1-9). The most frequently associated adverse events related specifically to EGEN-001 treatment were grade 1/2 fatigue, fever, chills, abdominal pain, nausea, vomiting, anemia, thrombocytopenia, and leukopenia. Three of 20 EGEN-001 treated patients evaluable for toxicity elected to withdraw from the study motivated in part by grade 1 treatment related toxicities. There were no patients with partial or complete response (0%; 90% CI 0-10.9%). Seven (35%) of 16 patients evaluable for response had stable disease, and 9 (45%) had progressive disease. Six (30%) patients had a PFS of greater than six months, although three had gone off study and onto other therapies before six months. The estimated six-month EFS was 15%. The median PFS and OS were 2.89 and 9.17months, respectively.
CONCLUSION: EGEN-001 at the dose and schedule evaluated was associated with some but limited activity and was seemingly less tolerated in platinum resistant recurrent ovarian cancer patients.