phosphorus-radioisotopes and Fallopian-Tube-Neoplasms

Topics: Fallopian Tube Diseases; Fallopian Tube Neoplasms; Female; Humans; Laparotomy; Phosphorus Radioisotopes

Imaging modalities to evaluate ovarian/fallopian tube cancer patients for recurrence are limited. Positron emission tomography (PET), computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound lack the sensitivity to consistently detect recurrence or measurable disease in these patients. A new technique combines PET and CT (PET/CT) images to identify increased metabolic activity and to locate that signal with improved anatomic specificity. The objective of this study is to compare PET/CT, CT, and histologic findings in patients with recurrent ovarian/fallopian tube cancers.. Retrospective chart review of eight patients with primary ovarian (n = 6) or fallopian tube (n = 2) cancer was performed. All eight patients underwent initial cytoreductive surgery. Five patients initially received chemotherapy, one received radioactive phosphorus ((32)P), one received tamoxifen, and one received no therapy. Seven of eight patients had a suspected recurrence based on clinical examination, elevated CA-125 level, and/or abnormal CT findings; one patient requested a PET/CT. Histologic findings from surgery were correlated with PET/CT and CT findings.. All eight patients had positive histology, and of these, seven patients had a negative CT and five patients had lesions that were correctly identified by PET/CT.. Five of the eight (62%) patients had recurrent disease based on correlative histology with a positive PET/CT and a negative CT. These preliminary findings suggest that combined PET/CT may be an effective means of identifying patients with recurrent ovarian/fallopian tube cancer. Such patients could potentially proceed to salvage treatment and avoid the morbidity and expense of surgical assessment. Pilot studies comparing CT, PET, PET/CT, and histologic findings are underway.

Topics: Aged; Fallopian Tube Neoplasms; Female; Humans; Middle Aged; Neoplasm Recurrence, Local; Ovarian Neoplasms; Phosphorus Radioisotopes; Retrospective Studies; Risk Factors; Tomography, Emission-Computed; Tomography, X-Ray Computed

Thirty-four patients with fallopian tube cancer were evaluated at the Mayo Clinic between 1964 and 1985 and received radiation therapy postoperatively. Employing a system analogous to FIGO ovarian cancer staging, there were 9 patients with stage I disease, 13 with stage II, and 12 with stage III/IV. Residual disease was present in 15 patients and absent in 19. Nodal metastases were documented in 12 patients or 35% (10 at presentation, two at relapse), with para-aortic nodes most commonly involved (67%) and 7 of the 12 having disease otherwise limited to the pelvis at presentation. Fifteen of 34 (44%) patients survived disease-free until intercurrent death or to a median follow-up of 70 months. Seven patients were treated with palliative intent for massive disease, and 27 patients were treated with curative intent (21 radiation alone, six radiation plus chemotherapy). Of those treated with curative intent, 15 patients received pelvic irradiation (with or without para-aortic nodal irradiation), 10 received whole abdominal irradiation, and 2 received intraperitoneal radiophosphorus. In the potentially curative group, seven of nine (78%) patients with stage I disease, five of 12 (42%) with stage II, and 2 of 6 (33%) with stage III have remained disease-free. Among the 21 patients with stage I or II disease, only four of the 11 (36%) patients who received pelvic irradiation alone were disease-free, but four patients had an isolated upper abdominal failure. In contrast, eight of 10 (80%) patients receiving treatment to the entire abdomen (including two patients who received 32P) were disease-free.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adenocarcinoma; Adenocarcinoma, Papillary; Evaluation Studies as Topic; Fallopian Tube Neoplasms; Female; Humans; Neoplasm Recurrence, Local; Neoplasm Staging; Phosphorus Radioisotopes

Forty-one cases of primary fallopian tube carcinoma treated at our institution over the years 1946 to 1976 are described. The overall 5-year survival rate was 34.4%, although patients with early tumors had a 72.7% survival rate. The single most important factor affecting survival appeared to be the extent of disease at the time of diagnosis. Past and present treatment modalities are discussed, and proposals for management of this disease are outlined.

Topics: Adenocarcinoma; Adult; Aged; Antineoplastic Agents; British Columbia; Dilatation and Curettage; Fallopian Tube Neoplasms; Female; Humans; Middle Aged; Neoplasm Staging; Phosphorus Radioisotopes; Radiotherapy, High-Energy

Topics: Adult; Aged; Antineoplastic Agents; Carcinoma; Colloids; Fallopian Tube Neoplasms; Female; Gold Colloid, Radioactive; Humans; Middle Aged; Palliative Care; Phosphorus Radioisotopes; Prognosis; Radiotherapy Dosage; Radiotherapy, High-Energy