Abstract: Background and purpose: Primary fallopian tube carcinoma (PFTC) is a rare female malignant tumor, and the diagnosis of PFTC is rarely considered preoperatively. It is an infrequent disease and hardly reported. In this study, we analyzed clinical characteristics in 101 PFTC patients and identified the prognostic factors for the disease. Methods: We reviewed medical records of patients with PFTC at the Obstetrics and Gynecology Hospital of Fudan University from January 2002 to December 2017. The data included age, menopause status, childbearing history, tubal ligation history, breast cancer history, symptom, pretreatment CA125 level, imaging findings, ascitic cytology, debulking surgery or not, pelvic lymphadenectomy or not, surgical stage, pathologic subtype, tumor diameter, immunohistochemistry and chemotherapeutic course. The mean follow-up time was 60.54 months (ranging from 5 to 141 months). The Kaplan-Meier method was used to measure the overall survival and progression-free survival. A Log-rank univariate analysis was used to determine the prognostic factors related to the survival rate. The COX model multivariate analysis was used to identify independent prognostic factors. Results: A total of 101 patients with PFTC were identified. The 5-year overall survival was 79.3%, the mean overall survival was 91.89 months (95% CI: 81.90-101.88), and the median overall survival was 100 months (95% CI: 93.94-106.07). The 5-year progression-free survival was 71.6%, the mean progression-free survival was 89.47 months (95% CI: 78.80-100.14), and the median progression-free survival was 98 months (95% CI: 77.69-118.31). The most common clinical presentation was adnexal mass (36.6%), followed by vaginal bleeding (14.9%) and no specific symptom (10.9%). Residual disease was optimal in 85 (84.2%) patients and suboptimal in 16 (15.8%) patients. The histological subtype was predominantly the serous type (91.1%). Sixty-one patients (60.4%) were diagnosed at Stage Ⅰ/Ⅱ postoperatively. Forty (39.6%) patients were in Stage Ⅲ/Ⅳ. Until the end of follow-up time, the recurrence rate of the group was 43.6%. Univariate analyses on overall survival revealed that the International Federation of Gynecology and Obstetrics (FIGO) stage (P＜0.001; HR=4.58; 95% CI: 2.361-8.882), with or without pelvic lymphadenectomy (P=0.002; HR=0.338; 95% CI: 0.170-0.673) and residual tumor (P＜0.001; HR=4.655; 95% CI: 2.007-10.794) were significant prognostic factors. Conclusion: The diagnosis of PFTC is rarely considered preoperatively. Its unique biological features and pathogenesis are still under study. FIGO staging, pelvic lymphadenectomy and residual tumor are the main factors affecting the prognosis of patients with PFTC.

Key words: Primary fallopian tube carcinoma, Overall survival, Progression-free survival, Pelvic lymphadenectomy, Residual tumor, Prognostic analysis