Nordin A J
Department of Obstetrics and Gynaecology, Musgrove Park Hospital, Taunton, Somerset, United Kingdom.
Obstet Gynecol Surv. 1994 May;49(5):349-61. doi: 10.1097/00006254-199405000-00026.
Case series and important case reports of primary fallopian tube carcinoma published in the English literature from 1973 to 1992 are reviewed. Meta-analysis revealed a mean age of presentation of 56.7 years, with a nulliparity rate of 27.5 per cent and a mean parity of 1.7. Abnormal vaginal bleeding and discharge, and pelvic pain are the most common presenting symptoms. Despite developments in cytology, transvaginal ultrasound, and tumor markers, most cases remain undiagnosed preoperatively. In addition to direct intraperitoneal spread, early lymphatic spread is now recognized as a frequent cause of treatment failure. FIGO has recently released a staging classification for fallopian tube malignancy incorporating detailed surgical staging, which should allow uniformity and comparison between future series. Treatment regimes are empirically based on therapy for epithelial ovarian malignancy, but none have been subjected to controlled trials. Recent case series support extensive debulking surgery and adjuvant platinum-based combination chemotherapy for optimizing prognosis, although results from radiotherapy and hormonal therapy are largely disappointing. Promise is expressed in tumor markers and "second-look" laparotomy for monitoring disease response and planning management.
回顾了1973年至1992年发表在英文文献中的原发性输卵管癌病例系列和重要病例报告。荟萃分析显示，发病的平均年龄为56.7岁，未生育率为27.5%，平均产次为1.7。阴道异常出血和分泌物以及盆腔疼痛是最常见的症状。尽管细胞学、经阴道超声和肿瘤标志物有所发展，但大多数病例术前仍未得到诊断。除了直接的腹腔内播散外，早期淋巴转移现在被认为是治疗失败的常见原因。国际妇产科联盟（FIGO）最近发布了输卵管恶性肿瘤的分期分类，纳入了详细的手术分期，这将使未来各系列研究具有一致性和可比性。治疗方案基于上皮性卵巢恶性肿瘤的治疗经验，但均未经过对照试验。最近的病例系列支持广泛的肿瘤减灭术和以铂类为基础的辅助联合化疗以优化预后，尽管放疗和激素治疗的结果大多令人失望。肿瘤标志物和“二次探查”剖腹术在监测疾病反应和制定治疗方案方面展现出前景。
