title: Primary Fallopian Tube Carcinoma: A Single-Institution Experience of 101 Cases: A Retrospective Study.
abstract: OBJECTIVE
  This study aimed to identify the prognostic factors for primary fallopian tube carcinoma.
  
  
  METHODS
  A retrospective analysis was conducted of the patients treated with primary surgery and adjuvant chemotherapy at the Obstetrics and Gynecology Hospital of Fudan University from February 2003 to December 2010. Cox proportional hazards model was used for univariate and multivariate survival analysis.
  
  
  RESULTS
  Included in this study were 101 patients with a median follow-up of 64 months and a mean age of 57 years. Latzko triad symptom of abdominal pain, vaginal bleeding or discharge, and palpable pelvic mass was reported in 14 patients, and elevated CA 125 (≥ 35 U/mL) was found in 63. Four patients were classified as grade 1, 31 were grade 2, and 66 were grade 3. The distribution of International Federation of Gynecology and Obstetrics stage was 33 at stage I, 28 at stage II, 39 at stage III, and 1 at stage IV. Ninety patients underwent optimal tumor debulking in which residual tumor was no larger than 1 cm, and 67 patients received no fewer than 6 cycles of postoperative chemotherapy with paclitaxel and carboplatin (TP)-based regimen. Recurrence occurred in 44 patients after a median of 20 months (range, 1-72 months). The 5-year overall survival rate was 67.7%, and the 5-year disease-free survival was 57.4%. Multivariate analysis revealed that International Federation of Gynecology and Obstetrics stage (I-II) [hazard ratio (HR), 2.670; 95% confidence interval (CI), 1.316-5.418; P = 0.007 vs HR, 2.716; 95% CI, 1.416-5.211; P = 0.003], pelvic lymphadenectomy (HR, 0.274; 95% CI, 0.136-0.555; P < 0.001 vs HR, 0.449; 95% CI, 0.227-0.888; P = 0.021), and cycles (≥ 6) of chemotherapy (HR, 0.480; 95% CI, 0.246-0.937; P = 0.031 vs HR, 0.521; 95% CI, 0.276-0.985; P = 0.045) might serve as independent predictors of both overall survival and disease-free survival.
  
  
  CONCLUSIONS
  Preoperative diagnosis of fallopian tube carcinoma is difficult due to the silent course of this neoplasm. Comprehensive surgical staging including pelvic lymphadenectomy followed by adequate cycles of chemotherapy is an important strategy to improve patients' prognosis.
authors.affiliation: *Obstetrics and Gynecology Hospital, and †Department of Obstetrics and Gynecology of Shanghai Medical School, Fudan University; and ‡Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, People's Republic of China.
authors.forename: Lingjie
authors.initials: L
authors.lastname: Bao
authors.forename: Yan
authors.initials: Y
authors.lastname: Ding
authors.forename: QingQing
authors.initials: Q
authors.lastname: Cai
authors.forename: Yan
authors.initials: Y
authors.lastname: Ning
authors.forename: Weiguo
authors.initials: W
authors.lastname: Hu
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Xue
authors.forename: Hong
authors.initials: H
authors.lastname: Sun
authors.forename: Keqin
authors.initials: K
authors.lastname: Hua
authors.forename: Xianrong
authors.initials: X
authors.lastname: Zhou
authors.forename: Xiaofang
authors.initials: X
authors.lastname: Yi
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D018284:Cystadenocarcinoma, Serous / Q000473:pathology / Q000628:therapy*; D016889:Endometrial Neoplasms / Q000473:pathology / Q000628:therapy*; D005185:Fallopian Tube Neoplasms / Q000473:pathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate