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Primary Fallopian Tube Carcinoma: A Single-Institution Experience of 101 Cases
  1. Lingjie Bao, PhD*,,,
  2. Yan Ding, PhD*,
  3. QingQing Cai, MD,
  4. Yan Ning, PhD*,
  5. Weiguo Hu, MD*,
  6. Xiaohong Xue, MD*,
  7. Hong Sun, PhD*,
  8. Keqin Hua, PhD*,
  9. Xianrong Zhou, PhD* and
  10. Xiaofang Yi, MD, PhD*,,
  1. *Obstetrics and Gynecology Hospital, and
  2. Department of Obstetrics and Gynecology of Shanghai Medical School, Fudan University; and
  3. Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, People’s Republic of China.
  1. Address correspondence and reprint requests to Xiaofang Yi, MD, PhD, 419 Fangxie Rd, Shanghai 200011, People’s Republic of China. E-mail: yix@fudan.edu.cn.

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.

  • Primary fallopian tube carcinoma
  • Prognosis
  • Chemotherapy
  • Lymphadenectomy

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Footnotes

  • This study was partially supported by NSFC Grant 81302261 and STCSM Grant 14411965700 (X.Y.).

  • The authors declare no conflicts of interest.

  • Compliance with Ethnic Standards: All procedures performed in this study involving human participants’ medical records were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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