Advanced fallopian tube carcinoma at FIGO stage III or IV presents significant surgical complexity. For female patients who carry a high perioperative risk or for whom achieving optimal cytoreduction at primary surgery is unlikely, the management approach differs from that of primary surgical candidates.
This protocol addresses females with FIGO stage III or IV fallopian tube carcinoma in whom either perioperative risk is high or the likelihood of achieving optimal cytoreduction with primary surgery is low.
In this setting, the recommended strategy is neoadjuvant chemotherapy administered before any surgical intervention is considered — the complete regimen, sequencing criteria, and conditions for interval surgery are provided in the full protocol.
When cytoreductive surgery is subsequently pursued, the clinical target is residual disease of 1 cm or less in maximum diameter or thickness.
DOI: 10.1200/JOP.18.00662
ASCO states that although primary cytoreductive surgery is preferred for patients with a high likelihood of achieving optimal debulking, women with high perioperative risk or a low likelihood of achieving optimal cytoreduction should receive neoadjuvant chemotherapy followed by possible interval surgery.
Conventional chemotherapy includes intravenous (IV) platinum and paclitaxel administered once every 3 weeks for six cycles.
Although the goal of cytoreductive surgery is no gross residual, debulking is considered optimal if residual disease is 1 cm or less in maximum diameter or thickness.
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