| Objective:To investigate the clinical characteristics and prognostic factors of primary fallopian tube carcinoma(PFTC).Methods:Retrospective analysis of the clinical characteristics and prognosis of 66 cases who accepted the initial surgical treatment and pathologically diagnosed PFTC at Qilu Hospital of Shandong University from Jan.2005 to Dec.2015.Mann-Whitney’s rank-sum test was used to compare the early-stage with advanced patients wheather their preoperative serum CA-125,CA-153,CA-199 levels existed difference;Kaplan-Meier analysis was used for survival analysis and Cox proportional hazards model was used for univariate and multivariate analysis.Results:The mean age of the 66 patients was 59.3 years(range 32 to 82),50 patients(78.5%)were menopausal."Trilogy of carcinoma tubae" was occurred in 8 cases(12.1%).Pelvic mass with vaginal drainage/bleeding or abdominal pain was occurred in 21 cases(31.8%).21 cases with just one of the three clinical manifestations,and 5 cases showed none of them.According to International Federation of Gynecology and Obstetrics(2013)Stage Classification,14 cases at stage I,9 cases at stage II,41 cases at stage III and 2cases at stage Ⅳ.The serum CA-125 was detected in 61 patients before operation and elevated CA-125(>=35 U/ml)was found in 50 cases(82.0%).The positive rates of preoperative serum CA-125 in each stage were as follows:57.1%(8/14)in stage I,55.6%(5/9)in stage II,97.2%(35/36)in stage III which 5 cases were missed,and 100%(2/2)in stage Ⅳ.The preoperative serum CA-125 levels between early-stage and advanced patients existed significant difference.(Mann-Whitney’s rank-sum test,Z=-3.988,P<0.001),then the preoperative serum CA-199 and CA-153 levels had not significant difference.According to WHO Classification of Tumours of Female Reproductive Organs(2014),postoperative pathology was divided into serous carcinoma(62 cases),all of them were high grade,mucinous carcinoma(1 case),clear cell carcinoma(2 cases)and high-grade serous carcinoma part with sarcomatoid differentiation(1 case).30 cases with none residual,6 cases were less than lcm residuals,28 cases were large than lcm residuals and 2 cases unknown.61 patients accepted adjuvant chemotherapy including paclitaxel combined with cisplatin(TP)/paclitaxel combined with carboplatin(TC)/cisplatin combined with cyclophosphamide(PC),and 45 cases received no fewer than 6 cycles.We observed that 25 patients relapsed in the process of follow-up,and the median time was 12 months(range 8-48 months).Among all of the 66 patients,median survival time was 48 months,3year survival rate was 62.5%,5 year survival rate was 35.6%,5 year survival rate of FIGO I-IV stages were 77.1%,42.3%,23.9%and 0,respectively(Log rank test,P<0.001).Multivariate analysis showed that residual tumor(HR=3.867,P=0.049),pathological type(HR=19.024,P=0.023)lymph node metastasis(HR=0.167,P=0.024)were predictors of overall survival.Conclusions:PFTC is most commonly found in postmenopausal women,and most of them has nonspecific clinical manifestation,which usually accompanies with elevated CA-125.The serum CA-125 is also associated with FIGO stage.The main histologic types is high grade serous carcinoma(HGSC).The primary treatment is surgery with postoperative chemotherapy.Pathological type,lymph node metastasis and residual of tumor are closely related to the prognosis of patients. |
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