Radiation Oncology/Fallopian tube

Staging AJCC 7th Edition (2009) Primary Tumor: (FIGO stage in parentheses) T1 (I) - limited to the fallopian tubes T1a (IA) - limited to one tube, without penetrating the serosal surface; no ascites T1b (IB) - limited to both tubes, without penetrating the serosal surface; no ascites T1c (IC) - limited to one or both tubes with extension onto or through the tubal serosa; or with malignant cells in ascites or washings T2 (II) - pelvic extension T2a (IIA) - extension and/or metastasis to the uterus and/or ovaries T2b (IIB) - extension to other pelvic structures T2c (IIC) - pelvic extension with malignant cells in ascites or washings T3 (III) - peritoneal implants outside the pelvis T3a (IIIA) - microscopic peritoneal metastasis outside the pelvis T3b (IIIB) - macroscopic peritoneal metastasis outside the pelvis, 2cm or less T3c (IIIC) - peritoneal metastasis outside the pelvis, more than 2 cm Regional Lymph Nodes: include pelvic, paraaortic, inguinal N0 - no N1 (IIIC) - yes Distant Metastases: M0 - no M1 (IV) - yes Stage Grouping: Follows FIGO stage above (in parentheses). T3c and N1 are both IIIC. Older staging editions AJCC 6th Edition (2002) No changes compared to 7th edition Risk Factors Harvard; 2007 (1999-2007) 17761984 -- "Primary fallopian tube malignancies in BRCA-positive women undergoing surgery for ovarian cancer risk reduction." (Callahan MJ, J Clin Oncol. 2007 Sep 1;25(25):3985-90.) Retrospective. 122 BRCA+ patients with prophylactic ovarian CA surgery. Median age 46 years Outcome: 6% early malignancy, 100% (n=7) originated in distal fallopian tube, 2 surface implants on the ovary Conclusion: Distal fallopian tube dominant site of origin for BRCA+ women at risk for GYN carcinomas Retrospective 9422560 (1960 - 1995) — "Adenocarcinoma of the fallopian tube: results of a multi-institutional retrospective analysis of 72 patients." Wolfson AH et al. Int J Radiat Oncol Biol Phys. 1998 Jan 1;40(1):71-6. Multicenter. 72 pts.