Malignant Lesions of the Fallopian Tube and Broad Ligament Follow-up

Author: Hetal B Gor, MD, FACOG; Chief Editor: Warner K Huh, MD more...

Updated: Feb 11, 2011

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Further Outpatient Care
Deterrence/Prevention
Prognosis
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Further Outpatient Care

Patients usually are evaluated using the CA-125 assay to monitor response to therapy. If a rise in CA-125 is noted, investigations such as CT scan and laparoscopy can be performed. Any evidence of disease can be treated with chemotherapy, debulking surgery, or both.

Deterrence/Prevention

Carriers of the BRCA gene, especially BRCA2, are recommended to take oral contraceptive pills initially. Once childbearing is over, prophylactic bilateral salpingooherectomy is recommended.

Prognosis

Good prognostic factors are as follows:

Negative peritoneal cytology
No residual disease at primary cytoreductive surgery
Disease limited to the pelvis
Abnormal vaginal bleeding as a presenting symptom
Negative second look laparotomy

Poor prognostic factors are as follows:

Advanced stage of the disease
Absence of fimbriated end closure in stage 1 disease
The presence of a TP53 mutation

The presence or absence of invasion of tubal wall, the depth of invasion when present, and the location of the tumor within the tube (ie, fimbriated or nonfimbriated) are prognostic variables.

The presence of ascites and the patient's age do not seem to affect prognosis because the prognosis depends on the location of the tumor within the fallopian tube and the depth of invasion of tumor; therefore, Navani suggests modification of the FIGO staging system.

Contributor Information and Disclosures

Author

Hetal B Gor, MD, FACOG Obstetrician/Gynecologist, Private Practice

Hetal B Gor, MD, FACOG is a member of the following medical societies: American College of Obstetricians and Gynecologists and Society of Laparoendoscopic Surgeons

Disclosure: Nothing to disclose.

Coauthor(s)

John Paulson, MD Clinical Professor of Obstetrics/Gynecology, Eastern Virginia Medical School; Professor of Clinical Obstetrics/Gynecology, Medical College of Virginia; Associate Director, Residency Program, Riverside Health System

John Paulson, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists and International College of Surgeons US Section

Disclosure: Nothing to disclose.

Specialty Editor Board

Karen Loeb Lifford, MD Director of General Gynecology, Associate Program Director, Department of Obstetrics and Gynecology, Instructor, Brigham and Women's Hospital, Harvard Medical School

Karen Loeb Lifford, MD is a member of the following medical societies: Association of Professors of Gynecology and Obstetrics, Massachusetts Medical Society, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Michel E Rivlin, MD Professor, Coordinator of Quality Assurance/Quality Improvement, Department of Obstetrics and Gynecology, University of Mississippi School of Medicine

Michel E Rivlin, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Medical Association, Mississippi State Medical Association, and Royal College of Surgeons of Edinburgh

Disclosure: Nothing to disclose.

Frederick B Gaupp, MD Consulting Staff, Department of Family Practice, Hancock Medical Center

Frederick B Gaupp, MD is a member of the following medical societies: American Academy of Family Physicians

Disclosure: Nothing to disclose.

Chief Editor

Warner K Huh, MD Professor, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Senior Scientist, Comprehensive Cancer Center, University of Alabama School of Medicine

Warner K Huh, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American College of Surgeons, American Society of Clinical Oncology, Massachusetts Medical Society, and Society of Gynecologist Oncologists

Disclosure: MERCK Consulting fee Consulting; GSK Consulting fee Consulting; ROCHE PHARMA/DIAGNOSTICS Consulting fee Consulting; HOLOGICS Consulting fee Consulting; HELIX BIOPHARMA Consulting fee Consulting; COVIDIEN Consulting fee Consulting; INTUITIVE SURGICAL Surgical Proctor

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