Related Experiment Video
Updated: Sep 14, 2025
Tubal Cytology of the Fallopian Tube as a Promising Tool for Ovarian Cancer Early Detection
Published on: July 25, 2017
Canadian Management of Serous Tubal Intraepithelial Carcinoma
Elisabeth Spénard1, Michelle Jacobson, Marjan Rouzbahman
1Division of Gynecologic Oncology and the Department of Pathology and Laboratory Medicine, CHU de Quebec, and the Department of Medicine, Laval University, Quebec City, and the Division of Gynecologic Oncology, CHUM, University of Montreal, and the Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, the Institute of Health Policy, Management and Evaluation, the Department of Obstetrics and Gynecology, Sinai Health Systems, the Department of Pathology and Laboratory Medicine, Toronto General Hospital, and the Division of Gynecologic Oncology, University of Toronto, the Familial Ovarian Cancer Clinic (FOCC) and After Care Clinic, Women's College Hospital, the Division of Gynecologic Oncology, Sunnybrook Health Sciences Centre, and the Division of Gynecologic Oncology, Princess Margaret Cancer Centre/Sinai Health Systems, Toronto, the Division of Gynecologic Oncology, Trillium Health Partner, Mississauga, and the Division of Gynecologic Oncology, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, the Department of Pathology and Laboratory Medicine and the Division of Gynecologic Oncology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, the Department of Pathology and Laboratory Medicine and the Division of Gynecologic Oncology, Foothills Medical Centre, University of Calgary, Calgary, and the Division of Gynecologic Oncology, Royal Alexandra Hospital, University of Alberta, Edmonton, Alberta, the Division of Gynecologic Oncology, Eastern Health, Memorial University of Newfoundland, St. John's, Newfoundland, the Division of Gynecologic Oncology, QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, and the Division of Gynecologic Oncology, HSC Winnipeg Women's Hospital, University of Manitoba, Winnipeg, Manitoba, Canada.
Objective:
To assess the management and outcomes of patients diagnosed with an isolated serous tubal intraepithelial carcinoma lesion across Canada.
Methods:
This retrospective study included consecutive patients with an isolated serous tubal intraepithelial carcinoma lesion diagnosed between 2006 and 2020 at 15 Canadian centers. Cases underwent multicenter panel pathology review.
Results:
Of 107 patients, 41 serous tubal intraepithelial carcinoma cases (38.3%) were identified at prophylactic surgery for germline pathogenic variants, 36 (33.6%) at surgery for suspicion of malignancy, and 30 (28.0%) at surgery for benign conditions. Treatment groups included observation (n=62, 57.9%), staging surgery (n=35, 32.7%), and adjuvant chemotherapy (n=10, 9.3%). Median follow-up was 55.5 months (interquartile range 30.26-82.07 months). Overall, nine patients developed high-grade serous carcinoma. The cumulative incidence of high-grade serous carcinoma was not significantly different between treatment groups ( P =.181); however, no patient treated with chemotherapy developed high-grade serous carcinoma. The cumulative incidence of high-grade serous carcinoma was 1.1% (95% CI, 0.1-5.3%) at 2 years and 5.7% (95% CI, 1.8-13.1%) at 5 years. No significant predictive factors were found on univariate analysis. After multicenter pathology review of 59 cases (55.1%), consensus diagnosis was reached: 45 (76.3%) with serous tubal intraepithelial carcinoma, three (5.1%) with serous tubal intraepithelial lesion, seven (11.9%) with high-grade serous carcinoma, and two (3.4%) with normal tissue. Of the cases reviewed, only 1 of 45 patients (2.2%) with confirmed serous tubal intraepithelial carcinoma developed high-grade serous carcinoma at 73 months, indicating a 5-year cumulative incidence of cancer of 2.6% (95% CI, 0.2-11.7).
Conclusion:
Management of serous tubal intraepithelial carcinoma varied across centers. The 5-year cumulative incidence of high-grade serous carcinoma after isolated serous tubal intraepithelial carcinoma was 5.7%, consistent with recent literature. However, multicenter pathology review revealed initial underdiagnosed high-grade serous carcinoma, and 5-year cumulative incidence of high-grade serous carcinoma after confirmed serous tubal intraepithelial carcinoma decreased to 2.6%, underscoring the importance of diagnostic confirmation by expert pathologists to guide accurate management.
