Primary carcinoma of the fallopian tube.
From 1964 through 1983, 47 patients with a mean age of 63 years underwent primary treatment of fallopian tube carcinoma. Vaginal bleeding, abdominopelvic pain or pressure, and a palpable pelvic mass (or masses) were frequent retrospective clinical associations. Survival analysis demonstrated a rapid initial rate of patient attrition with stabilization after 3 years, resulting in an overall 5-year survival rate of 41%. While independent of age, histologic grade, or original tumor size, patient longevity was significantly decreased (p less than 0.01) by the presence of disease beyond the pelvis, neoplastic cells in the peritoneal washings, and size of residual disease. Therapy consisted of primary surgical resection, usually followed by adjunctive radiotherapy or chemotherapy. Initial sites of relapse were predominantly (88%) within the intraperitoneal cavity. The study supports definitive surgical staging and tumor reduction, as well as more selective adjuvant therapy based on surgical stage and residual tumor size and location.