Improved survival for fallopian tube cancer

Abstract

BACKGROUND. Fallopian tube cancers are rare neoplasms. These malignancies are thought to behave biologically and clinically like ovarian cancer. The purpose of this study was to compare the clinical behavior and outcome of fallopian tube and ovarian cancer. METHODS. The Surveillance, Epidemiology, and End Results database was reviewed to identify women with tumors of the fallopian tube (FT) and ovary (OV) diagnosed between 1988 and 2004. Demographic and clinical data were compared, and the impact of tumor site on survival was analyzed using Cox models and the Kaplan‐Meier method. RESULTS. A total of 55,825 patients were identified, 1576 (3%) with FT and 54,249 (97%) with OV cancer. FT patients were more likely to present with early stage tumors (P < .001). Among FT patients, 47% had stage I/II tumors compared with 29% of OV cancers. In an adjusted Cox model of all patients, cancer‐specific mortality was 48% lower in FT patients (hazard ratio, 0.52; 95% confidence interval [CI], 0.48‐0.56) compared with OV cancer. Among patients with FT tumors, advanced age and stage were independent predictors of decreased survival. When stratified by stage, survival was similar for stage I and II tumors, but stage III and IV FT patients had an improved survival. The 5‐year survival for stage III FT cancer was 54% (95% CI, 48%‐60%), compared with 30% (95% CI, 29%‐31%) for OV. CONCLUSIONS. Fallopian tube cancers present earlier and at advanced stage have a better overall survival than primary ovarian malignancies. Future clinical trials should recognize the possible distinct clinical behavior of fallopian tube cancers. Cancer 2008. © 2008 American Cancer Society.

Early stage (IA-IB) primary carcinoma of the fallopian tube: case-control comparison to adenocarcinoma of the ovary

“…The databases lacked information on adjuvant therapy and cytoreductive status, on the quality of pathology review, and on the comprehensiveness of staging. Considering the high rejection rate in our study, it is likely that some non invasive tumors were included as invasive, and that a proportion of patients were actually stage IIIC in this paper and in other papers of the literature as well [5]. Our study is the only available one using strict inclusion criteria.…”

“…The analysis that all initially included stage of fallopian tube cancer was not complete because of the exclusion of early stage IA in this cohort. Another recent large retrospective study compared the clinical characteristics and outcomes for PCFT and OC (all stages confounded) retrieved from epidemiological databases [5]. The authors concluded that survival was similar for early stage (I and II) PCFT and OC (p=0.19).…”

“…Several reports have found that patients who received platinum based chemotherapy responded well to these treatments [5,13-17]. Recently, in a larger study, Pectasides et al [18] suggested the combination of carboplatin plus paclitaxel as the standard chemotherapy regimen for PCFT patients.…”

“…A recent retrospective case control study demonstrated that, for advanced stage PCFT, a similar survival outcome is obtained compared to OC patients, whereas the survival was better for early stage PCFT compared to OC [4]. Wethington et al [5], in an important retrospective comparison-control study, compared the outcome of 55,825 patients suffering from PCFT and OC. They found that early and advanced stage PCFT have a better overall survival than OC.…”

Erlotinib added to carboplatin and paclitaxel as first-line treatment of ovarian cancer: A phase II study based on surgical reassessment

“…1, 2 More than 75% patients with epithelial ovarian cancer present with advanced stage disease at presentation. 3 Despite improvements in survival using a combination of platinum and paclitaxel-based chemotherapeutic regimens, 4 only about 30% of patients with advanced stage ovarian carcinoma survive 5 years, and only about 10% are long term survivors. 3 Recent evidence suggests new cytotoxic regimens are not more effective than the standard regimen of carboplatin and paclitaxel.…”