Σταδιοποίηση σε Ca Σαλπίγγων

Ca Σαλπίγγων

AJCC Stages

Stages

T

N

M

0

Tis

N0

M0

IA

T1a

N0

M0

IB

T1b

N0

M0

IC

T1c

N0

M0

IIA

T2a

N0

M0

IIB

T2b

N0

M0

IIC

T2c

N0

M0

IIIA

T3a

N0

M0

IIIB

T3b

N0

M0

IIIC

T3c

N0

M0

Any T

N1

M0

IV

Any T

Any N

M1

(T) Primary Tumor

TNM

FIGO

Definitions

TX

Primary tumor cannot be assessed

T0

No evidence of primary tumor

Tis¹

Carcinoma in situ (limited to tubal mucosa)

T1

I

Tumor limited to the fallopian tube(s)

T1a

IA

Tumor limited to 1 tube, without penetrating the serosal surface; no ascites

T1b

IB

Tumor limited to both tubes, without penetrating the serosal surface; no ascites

T1c

IC

Tumor limited to 1 or both tubes with extension onto or through the tubal serosa, or with malignant cells in ascites or peritoneal washings

T2

II

Tumor involves 1 or both fallopian tubes with pelvic extension

T2a

IIA

Extension &/or metastasis of uterus &/or ovaries

T2b

IIB

Extension to other pelvic structures

T2c

IIC

Pelvic extension with malignant cells in ascites or peritoneal washings

T3

III

Tumor involves 1 or both fallopian tubes, with peritoneal implants outside the pelvis

T3a

IIIA

Microscopic peritoneal metastasis outside the pelvis

T3b

IIIB

Macroscopic peritoneal metastasis outside the pelvis ≤ 2 cm in greatest dimension

T3c

IIIC

Peritoneal metastasis > 2 cm in diameter

Liver capsule metastasis is T3/stage III; liver parenchymal metastasis is M1/stage IV; pleural effusion must have positive cytology for M1/stage IV. 
¹FIGO no longer includes stage 0 (Tis).

(N) Regional Lymph Nodes

NX

Regional lymph nodes cannot be assessed

N0

No regional lymph node metastasis

N1

IIIC

Regional lymph node metastasis

(M) Distant Metastasis

M0

No distant metastasis

M1

IV

Distant metastasis

Χαρακτηριστικά Επέκτασης

• Pattern of spread is similar to ovarian carcinoma
• Peritoneal spread
  • In approximately 80% of patients with advanced disease, metastases are confined to peritoneal cavity
• Lymphatic spread
• Lymphatic drainage of PFTC mirrors that of uterine fundus and ovaries
  • Along ovarian vessels → paraaortic nodes
  • Along broad ligament → pelvic nodes
  • Along round ligament of uterus → superficial inguinal nodes
• Early lymphatic metastases are common
• Incidence of positive nodes is 40–60% when there is extratubal tumor spread
• Can occur to liver, pleura, vagina, lungs, and brain
• Spread to proximal part of fallopian tube and uterus
• Hematogenous spread
• Transluminal spread

Κατηγοριοποίηση (Ιστολογικοί Τύποι)

Primary fallopian tube Ca (PFTC) include

• Papillary serous carcinoma (49.5-83.3%)
• Endometrioid (8.3-50%)

• Mixed (3.9-16.7%)
• Clear cell (1.9%)
• Transitional (11.7%)