Long-term follow-up of 46 cases of primary fallopian tube carcinoma: a single institute study.

Background Primary fallopian tube carcinoma (PFTC) is a rare malignancy. In recent years the incidence of PFTC has been rising. This study retrospectively analyzed 46 cases of PFTC to identify prognostic factors that may impact the survival of patients with PFTC and explored the clinical characteristics. Methods The clinical data of patients who had undergone surgery and adjuvant chemotherapy in Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University from 1995 to 2015 were retrospectively analyzed. We analyzed clinical data. Cox proportional hazards model was used for univariate and multivariate survival analysis. Results The level of CA125 increased in almost all patients with advanced-stage (stage III-IV) carcinoma and about half the patients with early stage (stage I-II) carcinoma. On ultrasound examination, 41 cases had pelvic mass, and five cases had intrauterine space-occupying lesion. Nine patients underwent curettage (19.6%). By the International Federation of Gynecology and Obstetricians (FIGO) staging system, the distribution of patients was 18 at stage I, 16 at stage II, 10 at stage III, and 2 at stage IV. The mainstay of treatment was surgical cytoreduction and platinum-based chemotherapy. Four patients had residual tumors diameter ≤1 cm (R1), 10 had residual tumors diameter >1 cm, and 32 had no macroscopic residual tumor (R0). Forty patients received postoperative intravenous (IV) chemotherapy. The five-year overall survival (OS) was 94.7% in stage I, 80.0% in stage II, 44.4% in stage III, and 0% in stage IV. Univariate and multivariate analysis revealed that residual tumor was independent prognostic variable for OS. Univariate and multivariate analysis revealed that ascites tumor cells and residual tumor were independent prognostic variables for progression free survival (PFS). Conclusions Any postmenopausal women with vaginal bleeding, vaginal discharge, or lower abdominal pain should be alert to PFTC. Complete tumor markers and imaging examination should be conducted as soon as possible to improve the early diagnosis rate of the disease. Regardless of whether the operation is a comprehensive staging operation or cytoreductive surgery (CRS), achieving satisfactory R0 can improve OS and PFS. It is important the ascitic fluid is tested for tumor markers in order to predict PFS.