Cancer of the ovary, fallopian tube, and peritoneum

In 2014, the Gynecologic Oncology Committee of FIGO revised the staging to incorporate ovarian, fallopian tube, and peritoneal cancer in the same system. Changing the staging system required extensive international consultation. The primary site (i.e. ovary, fallopian tube, or peritoneum) is designated, where possible. When it is not possible to clearly delineate the primary site, these should be listed as “undesignated” [1,2]. It has been presumed that fallopian tubemalignancies were rare [2]. However, histologic, molecular, and genetic evidence shows that from 40%− 60% of tumors that were classified as high-grade serous carcinomas of the ovary or peritoneummay have originated in the fimbrial end of the fallopian tube [3–8]. Therefore, the incidence of fallopian tube cancers may have been substantially underestimated. These new data support the view that high-grade serous ovarian, fallopian tube, and peritoneal cancers should be considered collectively, and that the convention of designating malignancies as having an ovarian origin should no longer be used, unless that is clearly the origination site. It has been suggested that extrauterine tumors of serous histology arising in the ovary, fallopian tube, or peritoneummight be described collectively as “Müllerian carcinomas” [1,2] or “pelvic serous carcinomas” [9]. The latter tumor designation is controversial because some peritoneal tumors might arise in extrapelvic peritoneum. Therefore, the simple term “serous carcinoma" is preferred, and most of these are high-grade serous carcinomas (HGSC). Although there has been no formal staging for peritoneal cancers, the FIGO staging system is used with the understanding that it is not possible to have a Stage I peritoneal cancer.