Primary cancer of the fallopian tube: report of 26 patients

Background. Due to rarity of fallopian tube cancer most series on this tumor are small and many problems have remained unsolved. The aim of this report is to review our experience with this neoplasm and to compare it with previously published data. Methods. Retrospective study of 26 patients with fallopian tube cancer treated in one institution between 1974 and 1994. All patients underwent primary surgical treatment and 18 received adjuvant therapy including pelvic irradiation in 14 cases and chemotherapy in four. Results. Relapse occurred in 18 out of 25 followed up patients. Upper abdominal component of relapse was encountered in 12 patients (67%), pelvic component - in eight (44%) and extraperitoneal component - in six (33%). Pelvic relapse occurred in two out of 13 followed up patients treated with postoperative irradiation and in six out of 12 who did not receive postoperative radiotherapy. Survival ranged from 6 to 218+months (median 23 months). Five-year actual survival was 33%. There were no 2-year survivors in patients presenting with stage II-IV disease. No correlation was found between tumor grade and survival. Conclusions. Fallopian tube cancer is a treatable disease but cure can be only achieved in patients with early tumor. Postoperative radiotherapy may result in better local control but does not preclude extrapelvic dissemination, therefore adjuvant chemotherapy should be considered in high risk patients. Registration of all new cases as well as prospective multicenter studies are warranted to establish optimal management.