eMedicine Specialties > Obstetrics and Gynecology > Gynecologic Oncology

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

Author: John Paulson, MD, Professor of Clinical Obstetrics/Gynecology, Eastern Virginia Medical School; Clinical Professor of Obstetrics/Gynecology, Medical College of Virginia; Associate Director, Residency Program, Riverside Health System
Coauthor(s): Hetal B Gor, MD, FACOG, Consulting Staff, Private Practice, Bergen County, New Jersey
Contributor Information and Disclosures

Updated: Oct 9, 2008

Follow-up

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.

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.

Miscellaneous

Medicolegal Pitfalls

Fallopian tube and broad ligament malignancies are rare gynecological malignancies. Diagnosing these malignancies at an early stage is difficult because of the lack of symptoms or the presence of nonspecific symptoms. Diagnosis usually is an incidental finding; therefore, medicolegally, it is possible that patients can sue because of a failure to diagnose the cancer at an early stage or preoperatively. In addition, no standardized treatment exists. Usually, these conditions are treated in a manner similar to that used for ovarian cancer intraoperatively. Chemotherapy or radiotherapy after surgery depends on individual preferences.

 


More on Malignant Lesions of the Fallopian Tube and Broad Ligament

Overview: Malignant Lesions of the Fallopian Tube and Broad Ligament
Differential Diagnoses & Workup: Malignant Lesions of the Fallopian Tube and Broad Ligament
Treatment & Medication: Malignant Lesions of the Fallopian Tube and Broad Ligament
Follow-up: Malignant Lesions of the Fallopian Tube and Broad Ligament
References
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References

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Further Reading

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Keywords

malignant lesions of the fallopian tube and broad ligament, fallopian tube malignancy, fallopian tube cancer, fallopian tube carcinoma, broad ligament malignancy, broad ligament cancer, gynecologic cancer, dysplasia, carcinoma in situ, CIS, endometriosis

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Contributor Information and Disclosures

Author

John Paulson, MD, Professor of Clinical Obstetrics/Gynecology, Eastern Virginia Medical School; Clinical Professor of 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.

Coauthor(s)

Hetal B Gor, MD, FACOG, Consulting Staff, Private Practice, Bergen County, New Jersey
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.

Medical Editor

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.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Michel E Rivlin, MD, Professor, Coordinator, 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.

CME Editor

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

Michel E Rivlin, MD, Professor, Coordinator, 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.

 
 
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