Primary Fallopian Tube Carcinoma: Results of a Single-Institutional Retrospective Analysis of 17 Patients with Evaluation of Staging and Prognostic Factors

OBJECTIVE: Primary carcinoma of the fallopian tubes is one of the less common gynecological cancers. It constitutes (0.14-0.18%) of gynecological malignancies. Our study aimed to review the managing process of primary carcinoma of the fallopian tubes in the mono-center institute and to identify prognostic factors impacting survival. STUDY DESIGN: A retrospective cohort study regarding patients with fallopian tube carcinoma treated between July 1991 and December 2005 was identified at the Tunisian anticancer institute “Salah Azaiez”. During this period, we have identified 17 patients. Data such as age, gravidity and parity, menopausal condition, symptoms reported by the patient on presentation, adjuvant therapy, stage of illness, surgical intervention, pathological findings, tumor recurrence, and previous surgical procedures were obtained from the patients’ reports. RESULTS: The average age at the time of diagnosis was 58 years. Fourteen of the included patients were postmenopausal. Surgery was the initial therapy for 15 patients. Optimal cytoreductive surgery was achievable in seven patients with no residual tumors. Histologic examination revealed that serous adenocarcinoma type was the predominant type. Two were in stage I and, four were in stage II; seven were in stage III and four in stage IV. The median follow-up time was 24 months. At the time of the final analysis, 11 patients died of disease. 5-year OS, DFS was 21% and 37% respectively. In our study, only the residual tumor was a significant prognostic factor predicting survival. CONCLUSION: Complete optimal surgery with no residual tumor was the main goal of the surgeon to improved survival in primary fallopian tube carcinoma.

Surgical evaluation and management of adnexal masses: A tertiary care center experience

Introduction: Intraoperative and postoperative outcomes of ovarian carcinoma patients who underwent cytoreductive surgery in our clinic has been evaluated with the measures of adjuvant chemotherapy requirement, recurrence and survival rates. Materials and methods: Cases who underwent cytoreductive surgery between 2018-2019 in our clinic are evaluated in aspects of age at diagnosis, menopausal status, pathological stage of tumor, size of tumor, mode of surgical therapy, duration of surgery, neoadjuvant/adjuvant therapy choice, follow-up protocol, synchronous/metachronous state, rate of relapses and survival. Results and discussion: The mean age of total 23 operated cases is 59±8.9. %69,6 of all cases is found to be primary ovarian carcinoma, whereas %30,4 is ovarian metastasis of other malignancies. Among metastatic cases, three is primary carcinoma of colon, one is gastric cancer and one is primary carcinoma of bladder. In other two cases, invasion of endometrial cancer to the ovary was observed. In addition to the standard surgical procedures, one case has undergone diagnostic mass resection, one sole total abdominal hysterectomy (TAH) and bilateral salpingooferectomy (BSO) and 21 omentectomy (OMT). Among these 21 cases one has undergone bilateral pelvic lymph node dissection and five (%21,7) bilateral pelvic paraaortic lymph node dissection (BPPLND). In addition to TAH, BSO, OMT and BPPLND; nine (%39,1) cases has undergone low anterior resection, one cystectomy, one distal pancreas resection and one partial gastrectomy. Three (%13) of the cases has been diagnosed in stage 1, one in stage 2, nine (%39,1) in stage 3 and ten (%43,5) in stage 4. Four (%17,4) of the cases had taken neoadjuvant chemotherapy priorly to the surgery. Twenty-one (%91,3) of the cases took adjuvant chemotherapy and one chemoradiotherapy. Relapses has been observed in the follow up of two (%8,7) cases. Nineteen (%82,6) of the cases are currently in disease-free state and four (%17,4) has been in exitus state. Conclusion: Surgery is the major modality of treatment in ovarian cancer. Various surgical resections by experienced gynecologists may be in need to achieve optimal cytoreduction and multidisciplinary approach is substantially important.