Fallopian tube cancer prognosis. Malignant tumors of the fallopian tubes. Etiology and pathogenesis

Fallopian tube cancer is the rarest malignant tumor among other oncological diseases of the female genital organs and is among the latter from 0.11 to 1.18%. The disease sometimes occurs in 17-19-year-old girls, sometimes in pregnant women, but is most often detected at 50-62 years of age. The likelihood of recurrence of fallopian tube cancer and the effectiveness of treatment directly depend on timely diagnosis and treatment. At the same time, at the preoperative stages, the diagnosis of a malignant process is carried out only six months to a year after the first signs appear, and in no more than 21% of cases.

Causes and stages of the disease

As a rule, a malignant neoplasm develops only in one fallopian tube (in 87 - 97%), moreover, more often in the left. At the same time, according to the data of various authors, the bilateral process can reach 30%. The main histological forms of the tumor are serous adenocarcinoma (on average in 70% of cases), endometrioid and mucinous (10%), clear cell (up to 4%), transitional cell (up to 1.5%) and undifferentiated cancer (about 1%).

In recent years, there have been assumptions by individual authors about the possibility of a viral nature of cancer development. There is also a certain genetic predisposition associated with the mutation of the BRCA1 and BRCA2 genes involved in protection against spontaneous DNA damage and in its restoration. However, most experts consider hormonal disorders in the pituitary-ovarian system of endocrine regulation to be the main cause.

Provoking factors include:

  • age over 40 years, especially the age of the postmenopausal period;
  • acute inflammatory processes of the uterine appendages, which occur in more than 30% of patients;
  • history of infertility, which is observed among 40-70% of women with fallopian tube cancer; the risk of its development in infertility is 5 times higher than that in women giving birth.

It is believed that primary cancer of the fallopian tube develops mainly in the fimbrial region (every 10th case), but much more common is a secondary malignant tumor that spreads invasively from the body of the uterus or ovary, as well as metastatic cancer from cancerous or digestive organs. (from the stomach or intestines).

From the fallopian tubes, the tumor can spread by hematogenous (through the blood), lymphogenous (the most common way of spread compared to the ovarian tumor) or implantation (to the contact surfaces) in the para-aortic (in 33%), inguinal and retroperitoneal lymph nodes, parietal lymph nodes and visceral sheets of the peritoneum, supraclavicular lymph nodes, into the ovaries, uterus and uterine ligaments, greater omentum, liver and diaphragm. Metastasis of a tubal malignant neoplasm to the lymph nodes occurs more often than that of the ovaries.

There are four stages in the development of primary cancer:

  • Stage I is a restriction of the spread of the pathological process only by the fallopian tube.
  • Stage II - restriction by one or both fallopian tubes, but with spread to the pelvic tissue or ovaries, that is, within the small pelvis.
  • Stage III - damage to one or both fallopian tubes, pelvic organs with metastasis to the para-aortic, iliac and inguinal lymph nodes.
  • Stage IV - the presence of a tumor in one or both fallopian tubes with spread to the pelvic organs and the presence of metastases not only in the para-aortic, iliac and inguinal, but also in distant lymph nodes.

Clinical picture

Compared to the ovaries, symptoms of fallopian tube cancer appear relatively early in the form of abnormal discharge. This is due to the fact that the fallopian tube communicates anatomically with the uterine cavity and through the cervical canal with the vagina. However, in more than 70% of cases, clinical manifestations are absent for a long time, and the emerging signs are nonspecific and diverse. Often, cancer is discovered incidentally during an ultrasound or pelvic exam for some other reason.

The clinical phenomenon pathognomonic for this pathology is the so-called "intermittent dropsy", which occurs in 3-15% of cases and represents periodic cramping pains in the lower abdomen, passing or significantly decreasing in intensity after the appearance of sudden copious watery discharge from the vagina and coinciding with a decrease in the size of the pipe, stretched in the form of a "saccular" formation. This symptom occurs in cases where it is periodically emptied into the uterine cavity with a “sealed” opening of the ampullary section.

The classic triad of symptoms is somewhat more common, suggesting the presence of a malignant tumor:

  1. Pathological secretions. Their volume can be from meager (smearing) to abundant, up to bleeding. Initially, the discharge has a serous-watery character, then serous-bloody, less often serous-purulent or the color of "meat slops". Their presence before diagnosis can be from 6 to 12 months.
  2. Pain in the lower abdomen, especially on the side of the lesion. Sometimes they are cramping in nature - in cases where the tube stretched by the liquid is emptied into the pelvic cavity or into the uterine cavity.
  3. Palpation of a volumetric formation with a diameter of about 3 cm or more to the left or right of the uterus during a gynecological examination.

More common is not the classic triad, but individual symptoms in the form of discharge of watery (in 50% of cases) or bloody (35%) nature, pain in the lower abdomen (47%), the presence of a formation with a diameter of 3 cm or more in the area of ​​​​uterine appendages ( 85%), the presence of fluid in the abdominal cavity (ascites) of varying severity (18%), as well as metastases in the inguinal and / or supraclavicular lymph nodes as the first manifestation of the disease (about 11%).

In addition, such non-specific signs of the presence of pathology are possible, such as unsatisfactory health, fatigue, general malaise and weakness, at later stages - fever, and with a widespread tumor process, intense abdominal pain, increased abdominal volume, urination disorders and symptoms of intestinal obstruction. In the case of secondary cancer, clinical symptoms are determined by damage to the main organ (, etc.).

Diagnosis of the disease

Taking into account the extremely low percentage of correct preoperative diagnosis (no more than 10%), and the lack of highly informative methods of the latter, most clinical institutions use the method of an integrated approach, including clinical symptoms, laboratory, instrumental and other diagnostic methods.

Of little diagnostic value is a cytological examination of vaginal discharge or smears from the cervical canal, which are positive (pathological cells are detected) in the presence of the disease in only 23% of cases. The collection of discharge from the genital tract by means of a special cap or swab inserted into the vagina for several hours increases the accuracy of a cytological examination somewhat.

One of the most promising studies in laboratory diagnostics, many experts consider the determination of the content of the CA-125 tumor marker circulating in the blood, which is a natural protein secreted into the bloodstream by tumor cells. The content of the tumor marker CA-125 in the blood increases in stages I and II of cancer in 68% of women, in stages III and IV - in 95%, on average - in 85% of women with the pathology under consideration. A slight increase in oncomarker indicators (no more than 35 U / ml) is possible during menstruation or. This method is the earliest and most sensitive in the progression and recurrence of a malignant tumor.

Ultrasound for fallopian tube cancer is relatively informative. The echographic picture usually resembles. Often it allows you to determine the cancer and some of its features, as well as the presence of free fluid in the abdominal cavity. When analyzing echographic images, there are three main types of them:

  • an oblong (sausage-shaped) formation, predominantly of a cystic nature, inside of which there are partitions of the “gear wheel” type or a small dense internal component, which is a papillary growth;
  • the same formation, but the dense component occupies a significant part of the latter;
  • a solid dense formation that has an ovoid or oblong shape.

Sometimes the ultrasonic structure does not correspond to any of these types and is defined as a multi-chamber dense cystic mass with a slightly reduced density or the same density as other tissues.

More informative is ultrasound with color Doppler mapping (CDC), which allows you to identify pathological blood flow, indicating malignancy of the tumor. This method makes it possible to diagnose pathology even in overweight women. The value and reliability of the method is much higher if its results are compared with the results of a cytological study of discharge from the cervical canal.

The most reliable diagnostic method, the information content of which reaches 90%, is computed tomography (CT), which is a layered diagnosis of the abdominal cavity, small pelvis and retroperitoneal space. However, the high cost and significant radiation exposure limit the use of CT. As a highly informative additional method, it is justified in case of doubtful results of other methods and in difficult diagnostic cases.

If a tumor, especially a recurrent one, is suspected, a diagnostic test is also indicated to determine the prevalence of metastases and a biopsy.

Fallopian tube cancer treatment

Due to the fact that this pathology is rare and the observed groups of patients are quite small, uniform standards for the treatment of women with cancer of the fallopian tube have not been developed. The main goals are the elimination of a malignant neoplasm, as well as therapy to prevent relapse and metastasis.

Surgical treatment

At the first stage, a radical surgical operation is carried out with a thorough staging of the tumor process. The optimal volume of the operation is considered together with the appendages, resection of the greater omentum and removal of the iliac lymph nodes on both sides, biopsy of the para-aortic lymph nodes and the peritoneum of the small pelvis for the purpose of histological examination, as well as taking swabs from the diaphragm and lateral channels of the abdominal cavity for cytological examination . If it is impossible to remove the iliac lymph nodes, their biopsy is performed.

At the late stage of the disease, when the tumor grows into neighboring tissues and organs, the so-called cytoreductive operation is performed - the maximum possible removal of the tumor mass. It is desirable that its residual volume is less than 2 cm. This is due to the fact that the smaller the size of the residual mass of formation after surgical treatment, the better the prognosis of the disease.

In addition, tumors of considerable size have areas with poor blood supply and a significant percentage of cells in which division is temporarily absent. After removing part of the tumor, these cells become active, and therefore more sensitive to the effects of chemotherapy drugs and radiation therapy, which contributes to partial, and sometimes complete regression of the tumor and increases the survival rate.

Chemotherapy

Due to the relatively late detection and early metastasis of a malignant neoplasm, the failure rate of surgical treatment is quite high, even when it is carried out at an early stage. Therefore, combination chemotherapy as an adjunct treatment for fallopian tube cancer is necessary at any stage of the disease.

Modern treatment regimens are a combination of Cyclophosphamide with platinum-based drugs - with Cisplastin, with Doxorubicin and Cisplastin, with Carboplstin. According to various authors, partial or complete tumor regression with such therapy occurs in 53-92%, and the 5-year survival rate is 51%. With tumor resistance to platinum drugs, drugs from the taxane group (Paclitaxel) are used. They are also used in combination with platinum agents for stage III-IV cancer. In the latter case, the 5-year survival rate reaches 30%.

Possible negative effects of chemotherapy are suppression of bone marrow function, hypersensitivity reactions and peripheral neuropathy that do not require discontinuation of the drug, a decrease in general immunity, weight loss, diffuse alopecia, skin rash, fatigue, disorders of the gastrointestinal tract, inflammatory processes and ulceration on the mucous membranes of the oral cavity. These phenomena gradually disappear after the cessation of the administration of chemotherapeutic drugs.

Radiation exposure to the pelvic area and the projection area of ​​the para-aortic lymph nodes is currently used only as the final stage of treatment.

Forecast

The prognosis for fallopian tube cancer is determined by the approximate percentage of survival over 5 years. Without combined treatment, this total figure is 35%, the figure for stage I of the malignant process is 70%, for stages II and III - about 25 - 30%.

The overall 5-year survival rate in cases of complex therapy (surgical treatment with chemotherapy and radiation therapy) at stages I and II is about 100%, without relapses - 80-90%, at stage III - about 28%.

These indicators largely depend on the type and degree of differentiation of the cancerous tumor, its metastasis, and the volume of surgical intervention.

A rather rare pathology in the gynecological field is considered fallopian tube cancer. It is diagnosed with a frequency of 0.1-1.19% of all malignant diseases of the reproductive organs in women. The highest incidence occurs after the age of 50 years. Unilateral lesion of the appendages with spread to the ampulla of the fallopian tube prevails over the bilateral process.

Malignant transformation of cells can be observed as a primary lesion, when the cancer forms initially in the tube, or secondary, in which the tube becomes malignant due to the spread of cancer from surrounding organs (uterus, ovary, bladder). In addition, adnexa can become malignant as a result of metastasis to distant organs, such as the mammary glands, intestines, or stomach.

"Tubal" cancer, based on the results of histological examination, is divided into serous, mucinous, transitional cell, endometrioid, clear cell or undifferentiated type.

Peculiarities

Oncoprocess, in which a malignant neoplasm is localized on the fallopian tube, is a cancer of the fallopian tube. Symptomatically, the disease is manifested by pain in the lower abdomen, serous, purulent discharge and an increase in the volume of the abdomen.

Diagnosis consists in studying the patient's complaints, conducting a histological examination, ultrasound and smear analysis. After confirming the diagnosis and establishing the stage of cancer, the volume of surgical intervention and the scheme of drug therapy are determined.

The reasons

Certain causes of the disease have not yet been identified. One has only to list the factors that increase the risk of cellular malignancy:

  • inflammation of the reproductive organs (adnexitis, endometritis, salpingitis);
  • lack of pregnancy, childbirth;
  • genital infections;
  • herpes virus and papilloma virus;
  • anovulatory cycle or lack of menstruation;
  • metastasis of a tumor of a different localization.

Oncological formation as it grows takes on the appearance of cabbage with a bumpy, finely fluffy surface and a grayish tint. The intratubal space decreases, patency is disturbed, hemorrhages and necrotic areas are observed. In addition, with a sealed ampoule, it is possible to form a cavity with blood, serous fluid or pus.

Symptoms and manifestation

Symptomatically, the disease is manifested by secretions of a serous, purulent or mixed nature. Bloody discharge is also possible. This is due to the release of decay products of cancer formation through the uterus and external genitalia.

A woman complains of bleeding that is not associated with the menstrual cycle, the appearance of spotting during menopause. At this stage, diagnostic curettage and examination of the removed material does not always make it possible to identify what delays the establishment of an accurate diagnosis.

A characteristic feature is considered to be periodic white abundant discharge, after the release of which there is a decrease in the volume of the neoplasm of the appendages. Pain sensations are observed on the side of the lesion, but sometimes they can be disturbed scattered in the lower abdomen with spread to the perineum. At first, the pains are irregular, cramping, then constant aching with spastic periods.

Of the general symptoms, it should be noted an increase in temperature to 37.5 degrees, general weakness, the appearance of ascitic fluid in the pelvis and damage to neighboring lymph nodes. They become painful when probing, enlarged, dense and motionless.

What examinations and analyzes are needed?

After the patient has contacted the gynecologist, studied complaints and gynecological examination, the doctor prescribes the following:

  • Ultrasound of the small pelvis (if necessary, computed tomography);
  • studies of smears and aspirate of the uterine cavity;
  • blood test for .

If, after performing the above examinations, there are doubts about the diagnosis, diagnostic laparoscopy is performed to visualize the neoplasm and assess the degree of damage to surrounding organs.

What drugs are used to treat fallopian tube cancer?

A chemotherapy course is rarely carried out with one drug, schemes are often used. For this, Cisplatin, Cyclophosphamide, Adriblastin, Vincristine, Actinomycin, Bleomycin, Paclitaxel, Ifosfamide and Etoposide are used. Combinations of these drugs can achieve good results.

Chemotherapy is prescribed in such cases:

  • after surgical removal of the uterus, appendages, greater omentum and lymph nodes to prevent relapse;
  • after removal of a part of the conglomerate with an inoperable tumor in order to inhibit the oncoprocess and destroy the remaining malignant tissues;
  • before surgery to improve the effect.

In addition, it should be noted that chemotherapeutic agents have a wide range of adverse reactions, therefore, the general condition may worsen on the background of their administration.

Surgical treatment of fallopian tube cancer

The volume of surgical intervention is determined by the prevalence of the malignant process. In most cases, it is the removal of the uterus with appendages, the greater omentum and nearby lymph nodes. The removed material is subjected to histological examination to confirm the stage of the cancer and to determine the regimen for the administration of chemotherapy drugs.

Thanks to combined treatment, it is possible to stop the malignant process and increase life expectancy.

Can you get pregnant with fallopian tube cancer?

The probability of pregnancy in a unilateral process is extremely small, since the tubal patency is disturbed due to the filling of its lumen with oncology and a pronounced adhesive process. As for the bilateral lesion, there are no chances for conceiving a baby.

Forecast

The prognosis is based on the oncological stage. At stage 1, the survival rate reaches 75%, at the 2nd stage it is in the range of 30-50%, as for stages 3 and 4, the survival rate does not exceed 3-14%. To crayfish fallopian tube was not diagnosed at a late stage, it is necessary to regularly visit a gynecologist and perform a pelvic ultrasound.

Epidemiology.

Malignant tumors of the fallopian tubes (RMT) are the rarest among other malignant tumors of the female genital organs, their frequency ranges between 0.13% and 1.8% and are among the understudied and difficult to diagnose neoplasms. RMT is recognized before surgery only in 2-10% of cases, and as a rule, in the later stages.

In the USA, 3.6 cases of this pathology are described per 1 million women.

Etiology.

A number of authors try to explain the rarity of RMT by the low mitotic activity of the normal endosalpinx. According to other sources, the reason that the body of the uterus and the cervix are more often affected by a tumor than the fallopian tubes, although they have the same embryonic origin (develop from the Müllerian passages), is the influence of exogenous carcinogens. The fallopian tube is more protected from the influence of carcinogens, because the isthmic sphincter prevents the penetration of fluid from the uterine cavity. With age, the muscle activity of the sphincter decreases, as does the peristalsis of the tube wall. With obliteration of the ampullar end of the tube, chronic stagnation of the secretion can be considered both as a factor preventing the occurrence of cancer and as a contributing factor, leading to the occurrence of hyperplastic processes in the epithelium.

At the Research Institute of Oncology. prof. N. N. Petrov, 57 patients with RMT were treated over a 30-year period. Approximately 1/3 of patients had a history of inflammatory diseases of the fallopian tubes, and almost every fourth patient had primary infertility.

As for the pathogenesis of RMT, taking into account the hormone dependence of the organ, it is permissible to assume that the development of tumors occurs under conditions of dyshormonal disorders in the "pituitary - ovary" system, as in the case of ovarian tumors. Age indicators of RMT patients also emphasize the existing relationship between the age-related increase in the level of gonadotropins in the blood and the increase in the incidence of tubal tumors. The average age is 55.7 years, i.e. The highest frequency of RMT falls on the same age category as endometrial cancer.

A cancerous tumor of the tube is most often localized in the middle and ampullar thirds of the tube, which is palpated as a retort-like body, usually of a cystic consistency, which is explained by the stretching of the tube by the fluid accumulating in its cavity. At the beginning of the development of the tumor, the surface of the formation is usually smooth, as it grows, it is bumpy.

Often occurring tears of the walls of the tube, especially with the rapid growth of the tumor, contribute to the formation of dense adhesions with the surrounding structures.

The histological classification of tubal tumors is represented by the following options:

papillary adenocarcinoma,

adenocarcinoma,

endometrioid adenocarcinoma,

glandular solid cancer,

Poorly differentiated cancer.

The clinical picture is not typical, which is why a correct diagnosis is rarely established before surgery. However, the study of symptoms shows that in 71.9% of observations, one of the first complaints of patients is of a different nature and intensity of discharge from the genital tract - bloody, sanious, purulent-bloody, abundant watery, appearing mainly in postmenopause. Such discharges almost always force a woman to see a doctor, and in more than half of these cases, diagnostic curettage is performed from the uterus, in some cases, repeated. True, not always, even in repeated scrapings, tumor tissue is found, and this circumstance causes the woman to be released without further attempts to clarify the cause of the discharge. The absence of oncological alertness continues, apparently, to play its negative role.

Along with the discharge, some patients have pain in the lower abdomen, which is sometimes cramp-like in nature. In some cases, the disease begins acutely with an increase in temperature to high numbers.

Basically, RMT is manifested by the classic triad of symptoms: pain, leukorrhea, metrorrhagia. However, the combination of these signs in one patient is observed no more than in 10-15% of cases. This is due to the fact that the prevalence of one or another symptom depends on the stage of tumor development.

Diagnostics.

On palpation, a tumor is found in the small pelvis, in the area of ​​​​the appendages, usually limitedly displaced, elongated.

It is important to take into account the predominantly elderly age of patients and the presence of discharge, to perform a thorough rectovaginal examination. As additional research methods, it is recommended to take an aspirate from the uterine cavity or obtain a scraping for subsequent morphological examination. At the same time, it is important to repeat the studies (taking an aspirate and / or scraping) if the first one gave negative results. Japanese scientists have found that the serological test for the tumor marker Ca-125 significantly increases depending on the stage of the disease. At I Art. it is increased in 20% of cases, in II - in 75%, in III - 89%, in IV - in 100% of patients. Performing ultrasound, CT is also highly desirable, since the results of the latter often help to clarify the diagnosis. It should be noted that due to the rarity of this pathology, we did not find in the literature a description of the ultrasound picture, CT, MRI data, and other radiation methods.

The correct diagnosis with RMT before surgery is extremely rare. According to various clinics - from 1 to 13%.

Metastasis in RMT is the same as in ovarian cancer: it spreads by germination or metastasis of the tumor within the pelvis (ovaries, body of the uterus, parietal and visceral peritoneum of the pelvis, omentum). Various groups of lymph nodes are affected: pelvic, lumbar, periuterine. Metastases to individual lymph nodes (mediastinum, supraclavicular) and organs (liver, lungs) are usually detected during the generalization of the tumor process. Dissemination is accompanied by ascites.

Clinical classification:

I stage AB - the tumor does not grow into the serosa, there is no ascites

IC - germination of serosa, presence of malignant cells in ascitic fluid.

IIA - spread of the tumor to the cervix, ovaries.

IIB - the tumor spreads to the pelvic organs.

IIC - distribution of the tumor to the pelvis + malignant cells in the ascitic fluid.

IIIA - micrometastases outside the small pelvis.

IIIB - macrometastases outside the small pelvis (2 cm or
IIIC - macrometastases > 2 cm, involvement of regional lymph nodes

IV - distant metastases.

The treatment of patients with RMT, judging by the literature data and our own observations, is almost always combined, consisting of either two components, for example, according to the option "surgery + radiation" or "surgery + chemotherapy", or three, when all 3 therapeutic effects are combined in one and the same patient. However, it should be emphasized that the optimal treatment option has not yet been proposed. There are no significant differences in treatment planning for patients with RMT and OC. Nevertheless, with cancer of the fallopian tubes, it is desirable, if technically possible, to use extirpation of the uterus with appendages, and not supravaginal amputation. Removal of the large omentum is mandatory. If the tumor is limited to the pelvic area - postoperative uniform irradiation at a dose of 46-48 Gy. Polychemotherapy regimens are the same as for ovarian cancer:

Cisplatin + cyclophosphamide - 75/750 mg/m2 once every 3 weeks;

Carboplatin + cyclophosphamide (AUC-5) 750 mg/m2 once every 3 weeks;

Cisplatin + doxorubicin + cyclophosphamide 50/50/500 mg/m2 once every 3 weeks;

Cisplatin + paclitaxel - 75/175 mg/m2 once every 3 weeks.

It is possible to use hormone therapy (progestogens + tamoxifen), the dose is selected individually.

Forecast.

The 5-year survival rate ranges from 10 to 44%.

There is every reason to believe that with timely diagnosis and the use of the optimal primary treatment option, which should consist of radical volume surgery followed by chemoradiotherapy, long-term results of treatment can be improved. The question of the role of prophylactic chemotherapy in the treatment of patients in remission after primary treatment should be studied using a special collaborative randomized trial.

prognostic factors.

Studying the prognostic factors of RMT has always been a difficult issue for clinicians. To date, there are no publications covering the multivariate analysis of this problem. The main prognostic criterion is the stage of the disease, the degree of differentiation, the volume of the residual tumor and lymphocytic infiltration. RMT is so rare that it is not possible to determine significant prognostic factors from single reports.

In most patients with this type malignant tumor the following symptoms will be observed: vaginal bleeding or discharge and / or pain in the lower abdomen. Abdominal bloating and imperative urge to urinate are less common. In many cases, these manifestations are vague and nonspecific.

The most characteristic symptom fallopian tube cancer (RMT) is vaginal bleeding: it is observed in approximately 50% of patients. Since the disease most often occurs in postmenopausal women and is manifested by bleeding, the presence of endometrial cancer (EC) should be excluded as the first hypothesis for differential diagnosis.

There is a need to seriously consider the possibility fallopian tube cancer (RMT), if diagnostic curettage of the uterine mucosa did not confirm RE, and symptoms persist. Vaginal bleeding results from the accumulation of blood in the fallopian tubes, which then enters the uterine cavity and is eventually expelled into the vagina.

Common symptom in fallopian tube cancer (RMT) - pain, usually has the character of colic and is often accompanied by vaginal bleeding. In most cases, the pain is relieved by the discharge of blood and watery secretions. Vaginal discharge is usually clear and occurs in about 25% of patients with fallopian tube cancer (RTC).

Fallopian tube cancer: treated patients.
Distribution by age groups.

The triad of pain, metrorrhagia, and leucorrhea, is considered pathognomonic for (RMT), but occurs infrequently. More common symptoms include pain with bloody discharge from the vagina. Pain in combination with copious, watery vaginal discharge, which is considered tubal dropsy, is reported to occur in less than 5% of cases. If the patient is examined at the time she has abundant dropsy of the fallopian tube, then often a volumetric formation is palpated in the pelvic region.

The size education may decrease during the study simultaneously with the release of watery leucorrhoea. After the cessation of watery discharge and a decrease in volume formation in the pelvis, the intensity of pain also decreases. Dropsy of the fallopian tubes is caused by the release of exudate by the tumor, which accumulates in the lumen of the tube and causes it to stretch, which, in turn, leads to the appearance of colic-like pain. Most often, the study determines a volumetric formation in the pelvis, which is usually mistaken for a fibrous tumor on the leg or an ovarian neoplasm.

This symptom is found more than half of the patients, another 25% of patients have a mass in the abdominal cavity, most often in the area of ​​​​the appendages, while in most cases the finding is interpreted as a fibrous tumor on the pedicle or an ovarian neoplasm. According to a meta-analysis conducted by Nordin in 1994, ascites occurs in 5% of patients. The clinical presentation of pelvic inflammatory disease in postmenopausal patients should raise the suspicion of fallopian tube cancer (RTC). Metastases in the inguinal lymph nodes are described, as well as several cases of paraneoplastic degeneration of the cerebellum.

Often the diagnosis is not made in time, late. According to a study by Eddy et al., symptoms appeared within 48 months, more than 50% of patients - within 2 months. or more. Semrad et al. indicated that about half of their patients had a 4-month delay between the onset of symptoms and the establishment of a diagnosis. Peters et al. reported that of the 115 patients they examined, 14% had no symptoms.

Malignant cells in the cytological examination of the material from the cervical canal reveal in 11-23% of patients with fallopian tube cancer(RMT). In patients with dropsy of the fallopian tube, the probability of detecting malignant tumor cells should be higher. Detection of psammoma bodies on cervical cytology in a postmenopausal woman is generally considered to be a sign of uterine cancer or clear cell carcinoma, with a high probability that their source is serous fallopian tube cancer (SMT) or ovarian cancer (OC).


Among all existing varieties of malignant oncological neoplasms, a tumor of the fallopian tubes is, according to statistics, one of the most common phenomena. In addition, experts believe that most tumors of the fallopian tubes of a malignant type are epithelial in their etiology.

Causes of Fallopian Tube Cancer

In most cases, this disease develops in women at a later age (about 50-60 years). However, doctors have not yet been able to find out the reason for this pattern. Fallopian tube cancer can recur even after treatment if a woman has already had lesions in the mammary glands, ovaries, or body of the uterus.

Fallopian tube cancer has many similarities with ovarian cancer: a similar structure, course of development, and also from the histological side. That is why doctors often use the same well-known methods to treat them.

Fallopian tube cancer symptoms

This disease can sometimes have an asymptomatic course, therefore, it is sometimes detected by chance during the examination by specialists. However, with fallopian tube cancer, women often have the following characteristic complaints:

  • heaviness and pain in the lower abdomen;
  • unusual discharge of a watery type (sometimes mixed with blood);
  • large pelvic mass.

At present, the exact clinical signs of fallopian tube cancer have not yet been determined. The most common symptom, which in some cases indicates the development of this disease, is extra-cyclic bleeding. Fallopian tube cancer often causes other ailments: for example, general weakness.

Methods for diagnosing the disease

To establish an accurate diagnosis, specialists use standard research methods: history taking, gynecological examination, ultrasound of the pelvic organs. An MRI, laparoscopy, or biopsy may also be additionally performed.

Fallopian tube cancer is localized in the peritoneum. Most often, during the diagnosis, patients already have metastases. At the same time, many lymphatic vessels are found in the fallopian tubes, through which lymph enters the pelvic and lumbar lymph nodes. According to statistics, approximately 33 percent of women have metastases in the lumbar lymph nodes by the time of diagnosis.

The stages of development of fallopian tube cancer are estimated by analogy with the classification of stages of ovarian cancer. At the same time, the doctor evaluates the stage of development using a laparotomy study.

The latest severe forms of fallopian tube cancer are diagnosed extremely rarely, since (unlike ovarian cancer), this disease begins to manifest itself and show symptoms at an earlier stage. Therefore, patients go to the doctor earlier.

Fallopian tube cancer treatment

Like ovarian cancer, this disease is treated using similar methods. In most cases, specialists use a surgical technique to cure fallopian tube cancer. Unfortunately, it is impossible to cure the patient with the help of a single removal of the tumor.

Therefore, specialists carry out a more complex operation for cancer of the fallopian tube, involving the removal of the greater omentum, as well as the extirpation of the uterus and the appendages themselves. The main task of the doctor in identifying a disseminated type of fallopian tube cancer is to eliminate the primary tumor completely.

Another method of treatment is monochemotherapy, which involves the use of cislatine and an alkylating agent. In this case, for fallopian tube cancer, doctors use the same sequence of treatment that is used in the treatment of ovarian cancer.

The effectiveness of radiation therapy, often used for cancer of the fallopian tube in the past, is still in question. Currently, this method is considered unproductive, since radiation therapy only treats the pelvic area, while the tumor tends to spread to other areas.

Prognosis for fallopian tube cancer

All patients, of course, are interested in the question of whether the survival rate is high after the diagnosis of fallopian tube cancer is established. It all depends on the stage of the disease. Naturally, the earlier the treatment was performed, the better.

According to statistics, about 40 percent of cured women live another five years after surgery. However, fallopian tube cancer, unlike ovarian cancer, is usually diagnosed already at the earliest stages of the disease, which can significantly improve the general condition of the patient and prolong her years of life after treatment for fallopian tube cancer.

Unfortunately, the statistics are inaccurate, as they do not have reliable confirmation. Most cases simply remain understudied.

Sarcoma is a malignant connective tissue tumor of the fallopian tube in the most dangerous form. This disease is usually detected already in the later stages in elderly patients. Sarcoma is treated with surgery and chemotherapy. Even if the treatment was successful, the survival rate is small: about 2 years.

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