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Journal of Cancer Research and Clinical Oncology

Erschienen in:

11.09.2020 | Original Article – Clinical Oncology

Increase of fallopian tube and decrease of ovarian carcinoma: fact or fake?

verfasst von: Anne Kathrin Höhn, Sabine Klagges, Albrecht Gläser, Sabine Taubenheim, Nadja Dornhöfer, Jens Einenkel, Grit Gesine Ruth Hiller, Christine E. Brambs, Lars-Christian Horn

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 3/2021

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Abstract

Purpose

Accurate disease classification is fundamental for the selection of the treatment approach, prognostication, selection of clinical trials and for research purposes in routine clinical practice. Extrauterine high-grade serous carcinoma (HG-SC) may arise from the ovary, the fallopian tube and rarely from the peritoneal surface epithelium. Regardless of its origin, the vast majority of patients with HG-SC share clinical symptoms, present with advanced stage disease and suffer from a poor prognosis. Recent data suggest that there is an increasing incidence of HG-SC arising from the fallopian tube.

Methods

Data from the Clinical Cancer Registry of Leipzig of surgically treated non-uterine pelvic carcinomas were analyzed regarding their sites of origin. Depending on the histology, cases were separated into high-grade serous and non-high-grade serous tumors. Based on different approaches in the assessment of the site of origin, three distinct time periods were defined. The frequency of the specific sites of origin was compared to the different time periods and histologic subtypes.

Results

The majority of cases (57.9%; 279/482) were high-grade serous carcinomas, 42.1% of the cases presented with endometrioid, clear cell or mucinous histology. Overall, a 1.7-fold decrease of carcinomas with ovarian origin, paralleled by a 10.3-fold increase of tubal carcinomas was noted between 2000 and 2019. Based on the histopathological subtype, there was a 2.1-fold decrease of ovarian and a 7.1-fold increase of tubal carcinomas in patients with HG-SC. In non-high-grade serous tumors, the frequency of the different sites of origin did not change. 83.7% of tumors with non-high-grade serous histology originated from the ovary, whereas 86.8% of the carcinomas with tubal origin were of high-grade serous histology.

Conclusion

The present and published data of non-uterine pelvic cancers may suggest an increase of tubal and decrease of ovarian carcinomas. However, there is rising morphologic and molecular evidence that non-uterine HG-SC actually arise from the fallopian tubes via its precursor STIC instead of from the ovary. This evidence has had an impact on the handling and reporting of non-uterine surgical specimens and its definition of the site assessment. In conclusion, the increasing frequency of tubal carcinomas and the associated decrease in ovarian cancer appears to be due to the reclassification of tumors previously classified as ovarian and greater emphasis on examining the resection specimens of non-uterine pelvic carcinomas.

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Titel: Increase of fallopian tube and decrease of ovarian carcinoma: fact or fake?
verfasst von: Anne Kathrin Höhn
Sabine Klagges
Albrecht Gläser
Sabine Taubenheim
Nadja Dornhöfer
Jens Einenkel
Grit Gesine Ruth Hiller
Christine E. Brambs
Lars-Christian Horn
Publikationsdatum: 11.09.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Cancer Research and Clinical Oncology / Ausgabe 3/2021
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-020-03387-4

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Increase of fallopian tube and decrease of ovarian carcinoma: fact or fake?