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Retrospective study of histopathological and prognostic characteristics of primary fallopian tube carcinomas: twenty-year experience (SOCRATE)
  1. Martina Borghese1,
  2. Giuseppe Vizzielli2,
  3. Giovanni Capelli3,
  4. Angela Santoro4,
  5. Giuseppe Angelico5,
  6. Damiano Arciuolo4,
  7. Nicoletta Biglia6,
  8. Annamaria Ferrero6,
  9. Luca Giuseppe Sgro6,
  10. Riccardo Ponzone7,
  11. Giovanni Scambia8,
  12. Anna Fagotti8 and
  13. Gian Franco Zannoni4,9
  1. 1Department of Obstetrics and Gynecology, Azienda Ospedaliera Ordine Mauriziano di Torino, Torino, Piemonte, Italy
  2. 2Department of Medical Area (DAME), University of Udine, Clinic of Obstetrics and Gynecology, "Santa Maria della Misericordia" University Hospital - Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
  3. 3Dipartimento di Scienze Umane, Sociali e della Salute, Università di Cassino e del Lazio Meridionale, Rome, Italy
  4. 4Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Unità di Gineco-patologia e Patologia Mammaria, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
  5. 5Pathology, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Unità di Gineco-patologia e Patologia Mammaria, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy, Rome, Italy
  6. 6Obstetrics and Gynecology, Azienda Ospedaliera Ordine Mauriziano di Torino, Torino, Piemonte, Italy
  7. 7Gynecological Oncology Unit, Candiolo Cancer Institute, FPO - IRCCS, Turin, Italy
  8. 8Gynecologic Oncology Unit, Women Wealth Area, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Catholic University of Sacred Heart, Roma, Italy
  9. 9Istituto di Anatomia Patologica, Università Cattolica del Sacro Cuore, Rome, Italy
  1. Correspondence to Dr Martina Borghese, Department of Obstetrics and Gynecology, Azienda Ospedaliera Ordine Mauriziano di Torino, Torino, Piemonte, Italy; martina.borghese1989{at}gmail.com

Abstract

Objective Primary fallopian tube carcinoma represents a rare entity, accounting for about 0.75%–1.2% of all gynecological malignancies. The rationale of our study is to describe the prognosis of primary fallopian tube carcinoma.

Methods We retrospectively identified patients with FIGO stage I–IV, all histology types and grading primary fallopian tube carcinoma treated in three major oncological centers between January 2000 and March 2020. Exclusion criteria were bulky tubo-ovarian carcinomas, isolated serous tubal intraepithelial carcinoma or neoadjuvant chemotherapy.

Results A total of 61 patients were included. The vast majority of primary fallopian tube carcinomas were serous (96.7%) and poorly differentiated (96.7%) and arose from the fimbriated end of the tube (88.5%). Larger tumor size correlated with higher probability of correct preoperative differential diagnosis of primary fallopian tube carcinoma (p=0.003). Up to 82.4% of patients with small tumors (≤15 mm) presented with high FIGO stage (≥IIA). The most common site of metastasis was pelvic peritoneum (18.8%) and among 59% of patients who underwent lymphadenectomy smaller tumors had higher rate of nodal metastasis (42.9%≤10 mm vs 27.3%>50 mm). After 46.0 months of mean follow-up there were 27 recurrences (48.2%). The most common site of relapse was diffuse peritoneal spread (18.5%). The 5-year disease-free survival was 45.2% and 5-year overall survival was 75.5%. Of note, 42.9% of patients with stage IVB survived >36 months.

Conclusion Primary fallopian tube carcinoma is a biologically distinct tumor from primary epithelial ovarian carcinoma and it is mostly located in the fimbriated end of the tube. In addition, it is characterized by a high rate of retroperitoneal dissemination even at apparently an early stage and its size does not correlate with FIGO stage at presentation.

  • fallopian tube neoplasms
  • cytoreduction surgical procedures
  • pathology

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Footnotes

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  • Contributors MB: conceptualization, data curation, methodology, roles/writing - original draft, guarantor. GV: conceptualization, writing - review and editing. GC: formal analysis, methodology. AS: writing - review and editing. GA: conceptualization. DA: conceptualization. NB: supervision. AF: writing - review and editing. LGS: writing - review and editing. RP: supervision, validation. GS: supervision, validation. AF: conceptualization, data curation, methodology, roles/writing - original draft. GFZ: conceptualization, data curation, methodology, roles/writing - original draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.