Horng Huann-Cheng, Teng Sen-Wen, Huang Ben-Shian, Sun Hsu-Dong, Yen Ming-Shyen, Wang Peng-Hui, Tsui Kuan-Hao, Wen Kuo-Chang, Chen Yi-Jen, Chuang Chi-Mu, Chao Hsiang-Tai, Chang Wen-Hsun
Division of Gynecology, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Department of Obstetrics and Gynecology, Cardinal Tien Hospital-Hsintien, New Taipei City, Taiwan; Department of Obstetrics and Gynecology, Fu Jen Catholic University, New Taipei City, Taiwan.
Taiwan J Obstet Gynecol. 2014 Sep;53(3):287-92. doi: 10.1016/j.tjog.2014.07.003.
Primary fallopian tube carcinoma (PFTC) is a rare gynecological malignancy with the following characteristics: its preoperative diagnosis is easy to miss or delay because of a lack of specific symptoms and signs; it is difficult to distinguish from serous epithelial ovarian cancer or primary peritoneal serous carcinoma during or even after operation because they have the same histopathological features; and there is uncertainty regarding the optimal management because of the lack of available standard guidelines. All of these factors contribute to the major challenge of undertaking a comprehensive study of this disease. To improve our understanding of this rare disease, the domestic data were summarized first. We searched PubMed on this topic, using the term "primary fallopian tube tumor and Taiwan" (from January 1, 1990 to November 3, 2013) and identified 15 published articles, but only 11 studies focused on the outcome of patients with PFTC in Taiwan. These limited data were not enough to increase our knowledge in dealing with this disease; therefore, the addition of large series or published review articles addressing this topic was needed. According to these reports, we concluded: (1) the main type of PFTC was serous type, often poorly differentiated; (2) the diagnosis of PFTC is frequently missed or delayed; (3) PFTC is often of an earlier International Federation of Gynecology and Obstetrics (FIGO) stage than is epithelial ovarian cancer (EOC), because of the appearance of earlier but nonspecific symptoms or signs, such as abdominal pain, vaginal bleeding, and watery discharge or mass; (4) the most important clinicopathological prognostic factor was FIGO stage; (5) the therapeutic strategy is still uncertain, but is often based on the guidelines for treating EOC. An intensive surgical effort such as a complete surgical resection or optimal cytoreduction surgery with a minimal residual tumor followed by a platinum-paclitaxel combination chemotherapy with/without targeted therapy (for example, antiangiogenesis agents) may provide the best possibility of disease-free or overall survival.
原发性输卵管癌（PFTC）是一种罕见的妇科恶性肿瘤，具有以下特点：由于缺乏特异性症状和体征，其术前诊断容易漏诊或延误；在手术过程中甚至术后，它很难与浆液性上皮性卵巢癌或原发性腹膜浆液性癌区分开来，因为它们具有相同的组织病理学特征；由于缺乏可用的标准指南，关于最佳治疗方案存在不确定性。所有这些因素都构成了对该疾病进行全面研究的重大挑战。为了增进我们对这种罕见疾病的了解，首先总结了国内数据。我们在PubMed上搜索了关于这个主题的内容，使用了“原发性输卵管肿瘤与台湾”（从1990年1月1日至2013年11月3日）这一检索词，共识别出15篇已发表的文章，但只有11项研究关注台湾PFTC患者的治疗结果。这些有限的数据不足以增加我们应对这种疾病的知识；因此，需要增加关于该主题的大型系列研究或已发表的综述文章。根据这些报告，我们得出以下结论：（1）PFTC的主要类型是浆液性，通常分化较差；（2）PFTC的诊断经常被漏诊或延误；（3）由于出现较早但非特异性的症状或体征，如腹痛、阴道出血、水样分泌物或肿块，PFTC的国际妇产科联盟（FIGO）分期往往比上皮性卵巢癌（EOC）更早；（4）最重要的临床病理预后因素是FIGO分期；（5）治疗策略仍不确定，但通常基于EOC的治疗指南。积极的手术努力，如完整的手术切除或进行最大限度的肿瘤细胞减灭术使残留肿瘤最小化，随后进行含铂紫杉醇联合化疗并加用/不加用靶向治疗（例如抗血管生成药物），可能提供实现无病生存或总生存的最佳可能性。
