A 10-year review of primary fallopian tube cancer at a community hospital: a high association of synchronous and metachronous cancers.

ABSTRACT

Primary fallopian tube carcinomas (PFTC) are rare gynecological tumors infrequently diagnosed prior to operative intervention. A retrospective review was performed to characterize the distribution and clinicopathologic significance of these tumors. Identification of PFTC was achieved through a review of the tumor registry and medical record ICD-9 codes at a community teaching hospital. A total of 1.5% of all gynecological cancers were PFTC. Most patients were presumed to have ovarian cancer. Ultrasound had the highest sensitivity (82%) for preoperative diagnosis. Surgical exploration was needed for definitive diagnosis in all patients. Optimal debulking was predictive of survival and of a negative second-look laparotomy (P < 0.05). Twenty-five percent of patients had a metachronous cancer diagnosed prior to their fallopian tube cancer, and 22% had a synchronous gynecological malignancy diagnosed at the time of surgical exploration. The response rate to platinum-based chemotherapy was 78%. The 5-year survival rate was 87%, and the overall survival rate was 75%. The median follow-up was 38 months. This report details the diagnostic and therapeutic experience of patients with PFTC and describes the occurrence of synchronous and metachronous gynecological cancers.