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Treatment and prognoses of fallopian tube carcinoma
GYNECOLOGIC ONCOLOGY 20, 247-270
(1985)
Abstracts Selected for Presentation at the Sixteenth Annual Meeting of the Society of Gynecologic Oncologists February 3-6, 1985 I. Treatment and Prognoses of Fallopian T~thr Carcinoma. A. GALAKATOS, AND H. M. CAMEL, Washington University 631 IO.
A. J. JACOBS, M-S. KAO. E. WOLFSOHN. School of Medicine. St. Louis. Missouri
Thirty-four patients (pts) with adenocarcinoma of the fallopian tube treated at the authors’ institution since 1960 were staged using the FIG0 schema for ovarian cancer. Ten had Stage (St) I disease, 6 St II, 14 St 111, and 4 St IV. The mean age was 57.0, with St I patients tending to be younger. Mean parity was 1.4. Six pts (17.6%) had another malignant tumor 3 to 13 years prior to diagnosis of tubal cancer. These included 4 with breast carcinoma (one of whom also had thyroid papillary cancer), I with colon carcinoma, and 1 with an ovarian thecoma. Primary surgical treatment has consisted mainly of TAH-BSO in St 1 and I1 (94%). and of TAH-BSO with (50%) or without (39%‘) further debulking in St III and St IV. Most St I lesions were treated with surgery alone (40%) or with adjuvant radiation (30%). Stages II-IV were treated with single-agent chemotherapy (CT) (38%) or combination CT (40%). Of the latter, S/IO received cisplatin, doxorubicin. and cyclophosphamide (PAC). Actuarial disease-free 2-year survival for Stages I-IV was, respectively 0.900, 0.833. 0.629, and 0.000. Five-year survival for Stages I-III was 0.514, 0.500, and 0.162. There was a significant difference in survival between early and late disease (P < 0.02). The PAC regimen seems promising in treatment of late disease, although too few patients have survived long enough to allow firm conclusions to be drawn. Early disease tended to demonstrate better differentiation than late disease. However, differentiation did not affect prognosis, when corrected for stage. Among patients with St I-III disease, half had distant metastases at the time of recurrence, while 35%. had distant metastases alone as the first manifestation of recurrence. 2. Primury Carcinoma of the Fallopian T&e: El,idenw .fiw Ac,ti\,ity of Cisplotin in Comhincrrior~ Therapy. W. Z. MAXSON, F. B. STEHMAN, T. M. ULBRIGHT. G. P. SUTTON. AND C. E. EHRLICH, Indiana University, Indianapolis, Indiana 46223. Case records of 25 patients treated for primary carcinoma of the fallopian tube between 1966 and 1983 were reviewed. Two charts had inadequate data to permit evaluation. Slides were reviewed on all patients. Two patients were considered to have in sir(c lesions and were excluded. The remaining 21 records were evaluated: initial stage was assigned according to the staging system of Dodson [Oh-Gvn 36, 935 (1970)]. Patients ranged in age from 16 to 88 years at the time of diagnosis. Pelvic mass was the most common preoperative finding. followed by abnormal bleeding and pain. Nine patients were assigned to Stage I, 5 to Stage II, 3 to Stage III. and 4 to Stage IV. All patients had adenocarcinoma and all tumors were unilateral. Fourteen patients had Grade 3 tumors. 6 Grade 2. and 1 Grade I. In patients with metastatic disease, involvement of the peritoneal surfaces, bowel, and omentum were noted most often. Only 5 patients had nodal sampling at initial diagnosis and 2 were positive. Lymph nodes were the most common site of recurrent disease (S/S). followed by vaginal apex (4/S). Fifteen patients received chemotherapy. 13 of whom received cisplatin + cyclophosphamide (PC) 2 doxorubucin (PAC). Six patients were treated for the primary disease with PC or PAC. There were 3 CRs, I PR, and 2 SD, compared to O/4 responses for patients treated with Alkeran. 247 0090-8258185 $ I .50 Copyright Y 1985 by Academic Pre\\. Inc. All right\ of reproduction in any form reserved.
(1985)
Abstracts Selected for Presentation at the Sixteenth Annual Meeting of the Society of Gynecologic Oncologists February 3-6, 1985 I. Treatment and Prognoses of Fallopian T~thr Carcinoma. A. GALAKATOS, AND H. M. CAMEL, Washington University 631 IO.
A. J. JACOBS, M-S. KAO. E. WOLFSOHN. School of Medicine. St. Louis. Missouri
Thirty-four patients (pts) with adenocarcinoma of the fallopian tube treated at the authors’ institution since 1960 were staged using the FIG0 schema for ovarian cancer. Ten had Stage (St) I disease, 6 St II, 14 St 111, and 4 St IV. The mean age was 57.0, with St I patients tending to be younger. Mean parity was 1.4. Six pts (17.6%) had another malignant tumor 3 to 13 years prior to diagnosis of tubal cancer. These included 4 with breast carcinoma (one of whom also had thyroid papillary cancer), I with colon carcinoma, and 1 with an ovarian thecoma. Primary surgical treatment has consisted mainly of TAH-BSO in St 1 and I1 (94%). and of TAH-BSO with (50%) or without (39%‘) further debulking in St III and St IV. Most St I lesions were treated with surgery alone (40%) or with adjuvant radiation (30%). Stages II-IV were treated with single-agent chemotherapy (CT) (38%) or combination CT (40%). Of the latter, S/IO received cisplatin, doxorubicin. and cyclophosphamide (PAC). Actuarial disease-free 2-year survival for Stages I-IV was, respectively 0.900, 0.833. 0.629, and 0.000. Five-year survival for Stages I-III was 0.514, 0.500, and 0.162. There was a significant difference in survival between early and late disease (P < 0.02). The PAC regimen seems promising in treatment of late disease, although too few patients have survived long enough to allow firm conclusions to be drawn. Early disease tended to demonstrate better differentiation than late disease. However, differentiation did not affect prognosis, when corrected for stage. Among patients with St I-III disease, half had distant metastases at the time of recurrence, while 35%. had distant metastases alone as the first manifestation of recurrence. 2. Primury Carcinoma of the Fallopian T&e: El,idenw .fiw Ac,ti\,ity of Cisplotin in Comhincrrior~ Therapy. W. Z. MAXSON, F. B. STEHMAN, T. M. ULBRIGHT. G. P. SUTTON. AND C. E. EHRLICH, Indiana University, Indianapolis, Indiana 46223. Case records of 25 patients treated for primary carcinoma of the fallopian tube between 1966 and 1983 were reviewed. Two charts had inadequate data to permit evaluation. Slides were reviewed on all patients. Two patients were considered to have in sir(c lesions and were excluded. The remaining 21 records were evaluated: initial stage was assigned according to the staging system of Dodson [Oh-Gvn 36, 935 (1970)]. Patients ranged in age from 16 to 88 years at the time of diagnosis. Pelvic mass was the most common preoperative finding. followed by abnormal bleeding and pain. Nine patients were assigned to Stage I, 5 to Stage II, 3 to Stage III. and 4 to Stage IV. All patients had adenocarcinoma and all tumors were unilateral. Fourteen patients had Grade 3 tumors. 6 Grade 2. and 1 Grade I. In patients with metastatic disease, involvement of the peritoneal surfaces, bowel, and omentum were noted most often. Only 5 patients had nodal sampling at initial diagnosis and 2 were positive. Lymph nodes were the most common site of recurrent disease (S/S). followed by vaginal apex (4/S). Fifteen patients received chemotherapy. 13 of whom received cisplatin + cyclophosphamide (PC) 2 doxorubucin (PAC). Six patients were treated for the primary disease with PC or PAC. There were 3 CRs, I PR, and 2 SD, compared to O/4 responses for patients treated with Alkeran. 247 0090-8258185 $ I .50 Copyright Y 1985 by Academic Pre\\. Inc. All right\ of reproduction in any form reserved.