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

Updated: Jan 24, 2019
  • Author: Hetal B Gor, MD, FACOG; Chief Editor: Warner K Huh, MD  more...
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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.

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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.

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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.

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