Overview
Metastatic disease to the fallopian tube is a rare occurrence, with the vast majority of fallopian tube cancers being primary epithelial ovarian cancers (EOC) that have spread 1. When metastatic disease involves the fallopian tube, it is typically secondary to a primary malignancy elsewhere in the pelvis or abdomen.Diagnosis
Evaluation for suspected stage III-IV epithelial ovarian cancer (which includes fallopian tube cancer) should include assessment by a gynecologic oncologist, cancer antigen 125 (CA-125) measurement, and computed tomography (CT) of the abdomen and pelvis, along with chest imaging 1.
Germline genetic and somatic testing should be offered to all patients with epithelial ovarian cancer at diagnosis 1.
Histologic confirmation of invasive ovarian cancer is required before neoadjuvant chemotherapy (NACT) 1.Management
For patients with newly diagnosed advanced epithelial ovarian cancer who are fit for surgery and likely to achieve complete cytoreduction, primary cytoreductive surgery (PCS) is recommended 1.
For patients fit for PCS but unlikely to achieve complete cytoreduction, NACT is recommended 1.
Patients with newly diagnosed advanced epithelial ovarian cancer and a high perioperative risk profile should receive NACT 1.
A platinum-taxane doublet is the recommended regimen for NACT 1.
Interval cytoreductive surgery (ICS) should be performed after a maximum of four cycles of NACT for patients who have responded to chemotherapy or have stable disease 1.
Hyperthermic intraperitoneal chemotherapy may be offered during treatment for patients with stage III disease, good performance status, and adequate renal function who are treated with NACT 1.Key Recommendations
Patients with suspected stage III-IV epithelial ovarian cancer should be evaluated by a gynecologic oncologist, with cancer antigen 125, computed tomography of the abdomen and pelvis, and chest imaging included 1. (Evidence: Expert opinion)
For patients with newly diagnosed advanced epithelial ovarian cancer who are fit for surgery and have a high likelihood of achieving complete cytoreduction, primary cytoreductive surgery is recommended 1. (Evidence: Expert opinion)
For patients fit for primary cytoreductive surgery but deemed unlikely to have complete cytoreduction, neoadjuvant chemotherapy is recommended 1. (Evidence: Expert opinion)References
1 Gaillard S, Lacchetti C, Armstrong DK, Cliby WA, Edelson MI, Garcia AA et al.. Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer: ASCO Guideline Update. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2025. link