Muntz H G, Tarraza H M, Granai C O, Fuller A F
Department of Gynecology, Massachusetts General Hospital, Boston.
Eur J Gynaecol Oncol. 1989;10(4):239-49.
Nineteen women with a mean age of 62 were treated for primary adenocarcinoma of the fallopian tube from 1960 to 1980. Common presentations were bleeding or discharge, pelvic mass, and pain. Cervical cytology was positive in five of eleven cases; endometrial curettings revealed adenocarcinoma in three of nine cases. Staging was by a system analogous to the International Federation of Gynecology and Obstetrics (FIGO) classification of ovarian carcinoma: 11% stage I, 44% stage II, 28% stage III, and 17% stage IV. Bleeding and abnormal cervical cytology were associated with earlier stage lesions and better prognosis. The most common treatment was excision of the primary tumor and gross intraperitoneal metastases. Total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed in 14 cases. Thirteen patients received 40-50 Gray of 2 MeV external beam pelvic radiation. Stages I and II had five-year survival of 100% and 63%. However, 38% of stage II patients had late extrapelvic relapses, and two early stage patients suffered serious complications of radiation therapy. All stage III and IV patients died of disease, 63% within the first 3 years. Based upon these results and review of other modern series, the importance of early diagnosis and complete surgical staging is emphasized, and stage-specific adjuvant therapy recommended.
1960年至1980年期间，对19名平均年龄为62岁的女性原发性输卵管腺癌患者进行了治疗。常见症状为出血或阴道分泌物、盆腔肿块及疼痛。11例患者中5例宫颈细胞学检查呈阳性；9例患者中3例子宫内膜刮除术显示为腺癌。分期采用类似于国际妇产科联盟（FIGO）卵巢癌分类系统：Ⅰ期占11%，Ⅱ期占44%，Ⅲ期占28%，Ⅳ期占17%。出血和宫颈细胞学异常与早期病变及较好预后相关。最常见的治疗方法是切除原发性肿瘤及肉眼可见的腹腔内转移灶。14例患者接受了全腹子宫切除术及双侧输卵管卵巢切除术。13例患者接受了2兆电子伏体外盆腔放疗，剂量为40 - 50戈瑞。Ⅰ期和Ⅱ期患者的5年生存率分别为100%和63%。然而，Ⅱ期患者中有38%出现盆腔外晚期复发，2例早期患者出现放疗严重并发症。所有Ⅲ期和Ⅳ期患者均死于疾病，63%在最初3年内死亡。基于这些结果及对其他现代系列研究的回顾，强调了早期诊断和完整手术分期的重要性，并推荐了针对不同分期的辅助治疗。
