Fallopian Tube Cancer Stage III

Stage 3 fallopian tube cancer means the disease has spread beyond the pelvis into the abdominal cavity or to nearby lymph nodes. This advanced stage requires a combination of treatments, and understanding what to expect can help you work with your healthcare team to plan the best approach for your situation.

Table of contents

• What is Stage 3 Fallopian Tube Cancer?
• Understanding the Staging System
• Stage 3 Substages
• Treatment Approaches

What is Stage 3 Fallopian Tube Cancer?

Fallopian tube cancer forms in the tubes that carry eggs from your ovaries to your uterus. Most fallopian tube cancer starts in the same tissue as ovarian cancer and primary peritoneal cancer. Healthcare providers diagnose, treat, and manage these cancers similarly^[6].

Stage 3 means that the cancer has spread outside the pelvis into the abdominal cavity (the space in your belly that contains your intestines, stomach, and other organs) or to lymph nodes. The lining of your abdominal cavity is called the peritoneum^[2].

Understanding the Staging System

Doctors use the International Federation of Gynecology and Obstetrics (FIGO) staging system to classify fallopian tube cancer. This system also applies to ovarian cancer and primary peritoneal cancer because these cancers form in the same type of tissue and are treated the same way^[2][9].

The staging system has four overall stages, numbered 1 to 4. Lower stages mean the cancer is more localized, while higher stages indicate the cancer has spread. Each stage can be further divided into substages labeled A, B, or C to provide more detailed information about the extent of the disease^[4].

Your doctor determines your cancer stage using the results of diagnostic tests, imaging scans, and samples taken from surgery. Generally, fallopian tube cancer stage refers to its pathological stage (surgical stage), which is determined by tissue samples surgically removed and examined under a microscope^[4].

Stage 3 Substages

Stage 3 fallopian tube cancer is divided into three groups: 3A, 3B, and 3C. Each substage describes different patterns of cancer spread.

Stage 3A has two groups. Stage 3A1 means the cancer has spread to the lymph nodes in the back of your abdomen (called retroperitoneal lymph nodes). This is further split into two categories: 3A1(i) means the cancer in the lymph nodes is smaller than 1 centimeter, and 3A1(ii) means the cancer in the lymph nodes is larger than 1 centimeter. Stage 3A2 means that there are cancer cells in the peritoneum. The cancer might also be in your lymph nodes^[2].

Stage 3B means there are cancer growths in the peritoneum that are 2 centimeters or smaller. There might also be cancer in the retroperitoneal lymph nodes^[2].

Stage 3C means there are cancer growths in the peritoneum larger than 2 centimeters. There might also be cancer in your lymph nodes or on the surface of your spleen or liver^[2].

Treatment Approaches

Treatment for stage 3 fallopian tube cancer typically involves a combination of surgery and chemotherapy. Your healthcare team considers several factors when deciding what treatment you need, including where the cancer has spread, whether the specialist surgeon thinks they can remove all the cancer, and your general health^[2].

Surgery is the main treatment if you are otherwise fit and well. Your specialist surgeon, called a gynaecological oncologist (a surgeon who specializes in cancers of the female reproductive system), will typically remove both ovaries, fallopian tubes, and your womb including the cervix. This operation is called a hysterectomy with removal of the ovaries (oophorectomy) and fallopian tubes (salpingectomy). They will also check where the cancer has spread in your pelvis and whether it is in your lymph nodes^[2][6].

Your gynaecological oncologist will aim to remove as much of the cancer as possible. This is called cytoreductive surgery. You may also hear it called debulking surgery^[2].

Chemotherapy uses drugs to kill cancer cells. You might receive chemotherapy after surgery, which is called adjuvant chemotherapy with cytoreductive surgery. Another approach is chemotherapy before and after surgery, called neoadjuvant chemotherapy with interval cytoreductive surgery. Some patients may receive chemotherapy into the abdomen during surgery, called hyperthermic intraperitoneal chemotherapy or HIPEC. Your healthcare team will discuss the best treatment approach for you. When you have chemotherapy will depend on your individual case^[2].

Some people may have treatment with a targeted cancer drug. This will depend on your situation. You might have a targeted cancer drug with chemotherapy, on its own, or after chemotherapy^[2].

If surgery is not possible because your cancer has spread widely or you are not well enough, you can have chemotherapy on its own to shrink the cancer as much as possible and to slow it down. You might have other treatments to help relieve your symptoms, such as treatment for fluid in the abdomen or radiotherapy to relieve symptoms like pain^[2].