Rose P G, Piver M S, Tsukada Y
Department of Gynecologic Oncology, Roswell Park Memorial Institute, Buffalo, NY 14263.
Cancer. 1990 Dec 15;66(12):2661-7. doi: 10.1002/1097-0142(19901215)66:12<2661::aid-cncr2820661233>3.0.co;2-t.
Sixty-four patients with primary fallopian tube cancer treated at Roswell Park Memorial Institute from 1964 to 1987 underwent retrospective clinicopathologic review. In 40 patients fallopian tube cancer was the only primary, but in 24 patients primary fallopian tube cancer was part of a multifocal upper genital tract malignancy. Of the 40 patients with unifocal fallopian disease, the median survival was 28 months. Only 15% of patients were alive and disease free with follow-up ranging from 22 to 141 months (median, 90.5 months). Survival was not associated with stage of disease, tumor histology, grade, or depth of invasion in this series. Fourteen patients who received cisplatin-based chemotherapy were evaluable for response. Three patients (21%) responded; two complete and one partial. Twelve patients without clinical evidence of disease underwent second-look procedures, ten laparotomy and two laparoscopy. Four of ten second-look laparotomies were negative. Secondary debulking was done in three of four patients with gross disease, one of which had a negative third-look laparotomy. Negative laparotomy, second-look or third-look, was associated with improved survival (P = 0.016). One of the two laparoscopies was negative, but the patient recurred. In the remaining 24 patients cancer of the fallopian tube was part of a multifocal upper genital tract malignancy. In 12 patients tubal disease was invasive, and in 12, it was in situ. Separate primaries occurred in the ovaries (n = 20); uterus (n = 7); and cervix (n = 2). This represents 1.3% of ovarian malignancies treated at Roswell Park Memorial Institute during the study period. Fallopian tube cancer seems as virulent as ovarian cancer with few long-term survivors. It is frequently associated with other sites of upper genital tract malignancy. Second-look laparotomy is an important predictor of survival. Second-look laparoscopy may be useful if positive.
对1964年至1987年在罗斯威尔公园纪念研究所接受治疗的64例原发性输卵管癌患者进行了回顾性临床病理分析。40例患者的输卵管癌为唯一原发性肿瘤，但24例患者的原发性输卵管癌是多灶性上生殖道恶性肿瘤的一部分。在40例单灶性输卵管疾病患者中，中位生存期为28个月。随访时间为22至141个月（中位时间为90.5个月），只有15%的患者存活且无疾病。在该系列研究中，生存情况与疾病分期、肿瘤组织学类型、分级或浸润深度无关。14例接受以顺铂为基础化疗的患者可评估疗效。3例患者（21%）有反应；2例完全缓解，1例部分缓解。12例无疾病临床证据的患者接受了二次探查手术，10例开腹手术，2例腹腔镜手术。10例二次探查开腹手术中有4例结果为阴性。4例有肉眼可见病变的患者中有3例进行了二次肿瘤细胞减灭术，其中1例第三次探查开腹手术结果为阴性。阴性的开腹手术、二次探查或三次探查与生存期延长相关（P = 0.016）。2例腹腔镜手术中有1例结果为阴性，但该患者复发。在其余24例患者中，输卵管癌是多灶性上生殖道恶性肿瘤的一部分。12例患者的输卵管疾病为浸润性，12例为原位癌。分别在卵巢（n = 20）、子宫（n = 7）和宫颈（n = 2）发生了独立的原发性肿瘤。这占研究期间罗斯威尔公园纪念研究所治疗的卵巢恶性肿瘤的1.3%。输卵管癌似乎与卵巢癌一样恶性，长期存活者很少。它常与上生殖道其他部位的恶性肿瘤相关。二次探查开腹手术是生存的重要预测指标。如果结果为阳性，二次探查腹腔镜手术可能有用。
