Analysis of treatment failures and survival of patients with Fallopian tube carcinoma: A cooperation task force (CTF) study

Objective. The objective of this retrospective multicenter study was to ass ess the pattern of failures and survival of patients with primary carcinoma of the fallopian tube. Methods. The hospital records of 88 patients with p rimary carcinoma of the fallopian tube were reviewed. Surgery was the initi al therapy for all patients. Tumor stage was I in 21 (23.9%), II in 21 (23. 9%), III in 43 (48.8%), and IV in 3 (3.4%) patients. Postoperative treatmen t was given without well-defined protocols. The median follow-up of survivo rs was 55 months (range, 7-182). Results. Of the 21 patients with stage I d isease, 10 had no postoperative treatment and 11 had platinum-based chemoth erapy. Five (23.8%) patients recurred after a median of 29 months (range, 8 -93) from initial surgery. Of the 21 patients with stage II disease, 2 had no postoperative treatment, 2 underwent external pelvic irradiation, 16 rec eived platinum-based chemotherapy, and 1 patient had oral melphalan. Eight (38.1%) patients recurred after a median of 25.5 months (range, 7-57). Of t he 46 patients with stage III-IV disease, 1 patient refused chemotherapy an d died after 19 months and 45 patients received platinum-based chemotherapy . A clinical complete response was obtained in 29 (64.4%) patients and a pa rtial response in 8 (17.8%). A second-look laparotomy was performed in 14 o f the 29 clinically complete responders: 12 patients were found to be in pa thological complete response and 2 had persistent disease. Six (50.0%) of t he former recurred after a median of 22 months (range, 13-101) from initial surgery. The two patients with persistent disease developed tumor progress ion after 15 and 11 months, respectively. Fifteen clinically complete respo nders did not undergo second-look, and 7 (46.7%) of them had a recurrence a fter a median of 18 months (range, 9-41). For the whole series, 5-year surv ival was 57%. By log-rank test, survival was related to FIGO stage (III-IV vs I-II, P = 0.0001), tumor grade (G3 vs G1 + G2, P = 0.0038), and patient age (> 58.5 years vs < 58.5 years, P = 0.0069), but not to histological typ e. The Cox model showed that FIGO stage (P = 0.0018) and patient age (P = 0 .0290) were independent prognostic variables for survival. Among the patien ts with stage III-IV disease, 5-year survival was 55% for the patients who had residual tumor <1 cm compared with 21% for those who had larger residuu m (P = 0.0169). Conclusions. Primary carcinoma of the fallopian tube shares several biological and clinical features with ovarian carcinoma. However, when compared with the latter, fallopian tube carcinoma more often tends to recur in retroperitoneal nodes and distant sites. Stage, patient age, and, among patients with advanced disease, residual tumor after initial surgery represent important prognostic variables for survival. (C) 2001 Academic P ress.