Clinical aspects, histopathology and genetics of fallopian tube cancer

Fallopian tube carcinoma is the least common type of all gynecologic malignancies. its low incidence led to therapeutic concepts derived from smaller retrospective studies with data collected over long time periods, resulting in a poorly defined management of this disease. As a result, every clinician is forced to decide on the basis of a low level of evidence. Alternatively, treatment of fallopian tube cancer today follows concepts derived from large prospective randomised trials in ovarian cancer. In comparison to ovarian cancer, fallopian tube carcinoma tends to be more often diagnosed as being of low FIGO stage at time of primary diagnosis, probably due to earlier symptoms. Together with increased retroperitoneal lymph node involvement, specific tumorbiological factors may be reasonable for that. However, despite these differences both malignancies share biological characteristics as well as clinical appearances. In keeping with standard treatment of ovarian carcinoma, recent results from retrospective trials with the largest collectives ever confirm the importance of cytoreductive surgery and platinum sensitivity for the treatment of fallopian tube cancer. Furthermore, strikingly similar frequencies of BRCA-1 and BRCA-2 mutations and patterns of genomic alterations in these tumour entities have recently suggested a common molecular pathogenesis. in summary of existing experiences, treatment of fallopian tube cancer may follow concepts derived from large prospective randomised trials in ovarian cancer.