Prognosis of primary fallopian tube adenocarcinoma: report of 25 patients

Purpose of investigation: Because of the rarity of primary fallopian tube a denocarcinoma (PFTA), the optimal management has not been well-defined, esp ecially in early-stage disease. Furthermore, prognosis of primary fallopian tube carcinoma has not been fully understood. Methods. We retrospectively studied patients with proven surgico-pathologic al 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 Stags III and IV. Twent y patients received adjuvant chemotherapy with four to eight courses of CAP or CEP (cyclophosphamide 500 mg/m(2), adriamycin 50 mg/m(2) or epirubicin 50 mg/m(2), and cisplatin 50 mg/m(2) intravenously, every three weeks) regi men. 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 a djuvant therapy. Results: Accumulative disease-free survival rate in spite of different st a ges 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 patient s with PFTA. However, multivariate analysis did not show significance due t o the small number of cases. Conclusion: Nearly half of the patients (44%) were diagnosed in early stags of PFTA, but patient survival was still disappointing. Understanding possi bile risk factors for therapeutic failure and more aggressive and effective multi-modality treatments should be further defined.