Prognosis of primary fallopian tube adenocarcinoma: report of 25 patients

Abstract

Purpose of investigation: Because of the rarity of primary fallopian tube adenocarcinoma (PFTA), the optimal management has not been well-defined, especially in early-stage disease. Furthermore, prognosis of primary fallopian tube carcinoma has not been fully understood.

Methods: We retrospectively studied patients with proven surgico-pathological stage PFTA and excluded patients without a standard surgicopathological staging procedure. Twenty-five patients from 1970 to 1995 were identified. Eleven were in Stage I, four in Stage II and ten in Stage III and IV. Twenty patients received adjuvant chemotherapy with four to eight courses of CAP or CEP (cyclophosphamide 500 mg/m2, adriamycin 50 mg/m2 or epirubicin 50 mg/m2, and cisplatin 50 mg/m2 intravenously, every three weeks) regimen. One patient received two courses of chemotherapy and another received one course of chemotherapy; both followed with radiotherapy due to refusal of further chemotherapy. The remaining three patients did not receive any adjuvant therapy.

Results: Accumulative disease-free survival rate in spite of different st ages was 36%. Univariate analysis showed postoperative adjuvant chemotherapy, optimal debulking surgery, nulliparity, extent of the disease, and tumor differentiation as significant factors for disease-free survival of patients with PFTA. However, multivariate analysis did not show significance due to the small number of cases.

Conclusion: Nearly half of the patients (44%) were diagnosed in early stage of PFTA, but patient survival was still disappointing. Understanding possibile risk factors for therapeutic failure and more aggressive and effective multi-modality treatments should be further defined.