Primary Fallopian Tube Carcinoma: Clinicopathological Analysis Of33Cases

Objective: Primary fallopian tube carcinoma (PFTC) is an uncommon diseaseaccounting for less than2%of gynecologic malignancies. Preoperative diagnosis ofprimary fallopian tube malignacy is very difficult,especially in the earlier stage,as it isnot routinely suspected.correct preperative diagnosis is made in only around0.4%ofcases(0.3-15%) and diagnosisi is more frequently made perioperatively orpostoperatively.disease is often found incidentally at laparotomy. The incidence ofPFTC does seem to be rising in developed nations as reported by a SurveillanceEpidemiology and End Results (SEER) study from the United States and aninvestigation from Finland.. The mean age of diagnosis is64years for patients withprimary fallopian tube carcinoma。Historically, patients with PFTC have been treated ina similar fashion to patients with ovarian carcinoma despite a lack of objective datasupporting this practice。To update our experience, we performed a retrospective chartreview to study patients diagnosed with primary fallopian tube cancer at our singleinstitution in an attempt to identify prognostic factors and clinical findings that areunique to patients diagnosed with PFTC.Methods: We reviewed33patients with Primary fallopian tube carcinoma fromDalian maternity hospital between January2003and December2009. The lastfollow-up time was January2013, We identified clinicopathological data to evaluatefactors important in recurrence, disease-specific and overall survival. Pathological wasadenocarinma. Patients with primary peritoneal or ovarian carcinoma were excludedfrom the study. tumor staging was based on the International Federation of Gynecologyand Obstetrics committee staging classification for fallopian tube malignancies2009.Cytoreduction was divided with venous thromboembolic events, which are consistentinto2groups as defined according to the GOG, as residual disease1cm or less andresidual disease greater than1cm. followed by visits: checking CA-125values, physical examination. Survival curves were obtained using the Kaplan-Meie method and themedian survival times compared by the log-rank test. Hazard rates were obtained usingCox regression (Cox proportional hazard model). The level of statistical significancewas set at0.05. Factors that achieved statistical significance were assumed to haveindependent influence on survival..Results: A total of33patients were included for analysis,.the mean age for ourpatient corhort was51years,the23patients of the corhort werepostmenopausal.women.and the median age at the postmenopausal was49years.mostof the patient had abdominal discomfort（42.5%）, vaginal bleeding/discharge was thesecong most common presenting symptom（33.3%）,and finally the presence of a pelvicmass..all of patient histological subtype was adenocarcinoma. Most patients werediagnosed with early-stage(51.5%) and advanced-stage disease (stages III and IV,48.5%). Most patients had pooly differentiated tumors(84.9%). The majority of patientstreated with chemotherapy platinum combination Taxane and84.8%patients hadextensive surgical.five patients had lymph node metastasis.all of33patient receivedsonography.in prepoerative.22patients on pulsed Doppler ultrasound shows lowvascular impedance,RI in the range0.24-0.82,the meadian RI was0.53,four patiwntsRI＜0.4;for patients early-stage the5-years survival rates was100%,andadvanced-stage disease was6.7%. as residual disease1cm or less was60.6%, residualdisease greater than1cm was0%. Factors important in disease-free survival wereInternational Federation of Gynecology and Obstetrics stage, tumor laterality(unilateraldisease vs bilateral disease).whereas International Federation of Gynecology andObstetrics stage, and residual disease were prognostic factors for overall survival. serumCA-125, tumor laterality(left-sided disease vs right-sided disease), poorly differentiatedwere nonsignificant in predicting overall survival and disease-free survival. Most of thepatients with recurrent disease in our study had intraperitoneal recurrences. Mostpatients, regardless of recurrence site, were treated with chemotherapy.Conclusions: Primary fallopian tube carcinoma is a rare tumor, Preoperativediagnosis of primary fallopian tube malignacy is very difficul. the most sign of PFTC arepelvic pain,second are vaginal bleeding, Accordingly surgeons perform staging surgeryFactors important survival were International Federation of Gynecology and Obstetricsstage and residual disease. evaluating CA-125values during routine clinic visits to helpidentify patients with recurrent disease early if a hydrosalpinx or adnexal mass ofunknown location is shown on imaging in older women, especially postmenopausalwomen, the possibility of PFTC should be considered.