Abstract 260: Incidence rates and outcomes of fallopian tube carcinomas: Data from the North American Association of Central Cancer Registries
Authors: Sherman Mark E. , Coburn Sally B. , Yang Hannah , Anderson William , Rosenberg Philip , Gierach Gretchen , Wentzensen Nicolas , Cronin Kathy , Trabert Britton 
Published: July 2017

Background: Serous tubal intraepithelial carcinoma (STIC) is hypothesized to give rise to many cancers that have been historically classified as ovarian primaries. Although STIC is gaining status as a diagnostic entity, similar appearing lesions would likely have been reported as fallopian tubal carcinoma in-situ (FT-CIS) in the past. Accordingly to characterize patterns of reporting and behavior for tubal cancers, we analyzed population-based data for incidence rate trends, co-occurrence with cancer at other sites and survival of FT-CIS and invasive fallopian tube carcinoma (FT-Inv).

Methods: We analyzed data for FT-CIS and FT-Inv included within 33 registries using the Cancer Incidence in North America Deluxe Analytical Files provided by the North American Association of Central Cancer Registries (1995-2012). Primary site of invasive carcinomas were defined according to the International Classification of Diseases for Oncology (3rd edition) topography codes (ovarian (C56.9), fallopian tube (C57.0), and primary peritoneal cancers (C48.1-.2, 48.8)). We excluded cancers with non-epithelial histology. Total counts, incidence rates per 1 million adjusted to the 2000 standard US population and age-standardized stage-specific survival were computed. Temporal incidence rate patterns were analyzed by joinpoint regression with estimates of annual percentage change (APC).

Results: Cases in which the first cancer diagnosis was FT-CIS, included 98 FT-CIS alone; 27 FT-CIS followed by another cancer diagnosis within 1 year and 172 cases in which FT-CIS was diagnosed concurrently with another cancer as compared with 5513 invasive tubal carcinomas over the same period. The incidence rate of FT-CIS was stable from 1995-2002, then significantly increased from 2002-2012 [APC (95% CI) = 16.2% (10.9-21.7)]. Rates of early stage high-grade serous FT-Inv increased significantly from 2002-2012 [10.4% (6.1-14.9)] and rates of late stage high-grade serous FT-Inv rose sharply from 2002-2012 [20.0% (17.5-22.6)]. Five-year age-standardized survival for women with FT-CIS only was 75.6% overall, reflecting 89.1% survival for women less than 50 years and 70.9% for women 50 years or older; survival for high-grade early stage serous FT-Inv was 77.8%.

Conclusions: Diagnoses of FT-CIS and FT-Inv have increased dramatically, likely reflecting changes in diagnostic pathology practice. Developing standardized reporting for FT-CIS (and in the future, STIC) when present with concurrent invasive cancer are needed, given that this occurs often. Based on limited data, 5-year survival for FT-CIS and early stage FT-Inv are similar, but future studies to evaluate data for STIC will be required, which will likely be achievable only through national registries that are large enough to capture sufficient cases.

Citation Format: Mark E. Sherman, Sally B. Coburn, Hannah Yang, William Anderson, Philip Rosenberg, Gretchen Gierach, Nicolas Wentzensen, Kathy Cronin, Britton Trabert. Incidence rates and outcomes of fallopian tube carcinomas: Data from the North American Association of Central Cancer Registries [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 260. doi:10.1158/1538-7445.AM2017-260