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Updated: Jun 21, 2026
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Tubal Cytology of the Fallopian Tube as a Promising Tool for Ovarian Cancer Early Detection
Published on: July 25, 2017
Coexistent Endometrial and Fallopian Tube Carcinoma: Molecular and Pathological Features for Risk Stratification
Kianoosh Keyhanian1, C Blake Gilks2, Elizabath Priya Mathew1
1Department of Pathology of Laboratory Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada.
Summary
This study adapted FIGO 2023 criteria for co-existent endometrial and fallopian tube carcinoma, identifying a low-risk group with no recurrences. Refining criteria with molecular features may expand this low-risk category for potential treatment de-escalation.
Area of Science:
- Gynecologic Oncology
- Pathology
- Molecular Diagnostics
Background:
- Co-existent endometrial and ovarian carcinoma (CEOC) meeting FIGO 2023 IA3 criteria have an excellent prognosis.
- Excluding high-risk molecular subtypes (MMRd, p53abn, NSMP ER-low/negative) improves risk stratification in CEOC.
- Co-existent endometrial carcinoma (EC) with fallopian tube (FT) involvement is classified as advanced stage (pT3/FIGO III).
Purpose of the Study:
- To evaluate if FIGO 2023 IA3 criteria can identify low-risk patients with co-existent endometrial and FT carcinoma.
- To determine if molecular features can further refine prognostic stratification in this patient group.
- To explore potential treatment de-escalation strategies for identified low-risk patients.
Main Methods:
- Retrospective analysis of 71 patients with pT3a EC and FT involvement from two institutions.
- Exclusion of cases with nodal, pelvic, vaginal, parametrial, adnexal soft tissue, peritoneal involvement, or neoadjuvant therapy.
- Application of FIGO 2023 IA3 criteria and molecular profiling (MMRd, p53abn, NSMP ER-low/negative) for risk assessment.
Main Results:
- Eight patients (11.3%) met the adapted FIGO 2023 IA3 criteria with zero recurrences.
- A modified approach excluding adverse molecular features and including ovarian/bilateral adnexal involvement identified 11 patients (15.5%) with no recurrences.
- Recurrences (19.7%) were predominantly associated with high-grade endometrioid or non-endometrioid histotypes and adverse molecular features.
Conclusions:
- Adapted FIGO 2023 IA3 criteria can identify a subset of patients with co-existent endometrial and FT carcinoma at low risk of recurrence.
- Incorporating molecular features and expanding pathological criteria can potentially identify a larger low-risk group.
- These findings support considering treatment de-escalation for selected patients with uterus/adnexa-confined carcinoma and indolent disease behavior.
