Malignant Lesions of the Fallopian Tube and Broad Ligament Treatment & Management

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

Medical Care

Medical care for fallopian tube and broad ligament malignancy depends on frozen section and pathology results, as summarized below.

Stage 0 - Carcinoma in situ

Negative cytology results: No further treatment

Positive cytology results: Intraperitoneal platin-based chemotherapy

Stage I

Negative cytology results: No treatment or short-term cisplatin therapy

Positive cytology results: Intraperitoneal cisplatin, but it is associated with more toxicity or short-term platin-based and taxol-based chemotherapy

Stage II-IV

Bulky residual disease or positive nodes: Three cycles of neoadjuvant chemotherapy taxol-based and platinum-based, debulking followed by 3 more cycles of chemotherapy.

No residual disease, negative nodes: Six cycles of taxol-based and platin-based chemotherapy

Treatment of broad ligament malignancy is similar to that for fallopian tube malignancy except in young patients, in whom wide local excision can be adequate.

In a 2012 study, patupilone was not better than standard therapies in treating resistant cases of recurrent ovarian, tubal or primary peritoneal cancer. [11]

Consultations

Consider consultations with the following specialists:

  • Gynecologic oncologist

  • Medical oncologist

  • Surgical pathologist

  • Social worker

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Surgical Care

Surgical care includes (1) total abdominal hysterectomy with bilateral salpingo-oophorectomy, (2) omentectomy and peritoneal washing, and (3) selective pelvic and para-aortic lymphadenectomy.

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