Rrituh Journal zyxwvutsrq of zyxwvutsr Ubsterics and Gynaccologj~ September 1990, zyxwvuts Vol. 97, zyxwvutsr pp. 822-826 The management of primary fallopian tube carcinoma HOWARD GURNEY, DAMIAN MURPHY, DEREK CROWTHER Summary. The outcome of 30 patients with primary fallopian tube car- cinoma is described. Treatment varied over the 22 year period of accrual and included combinations of surgery, radiotherapy and chemotherapy. There was an apparent increase in stage at treatmcnt with time which was probably related to more precise staging at laparotoiny and the greater use of computerized tomography. The median survival for all patients was 28 months and the 5-year survival was 18%. Ten patients received postoperative chemotherapy for residual disease with an over- all response rate of 80% and median progression-free and overall sur- vival times of 14 and 21 months respectively. The pattern of relapse was similar to that seen in ovarian carcinoma, with all but one patient having the pelvis or abdomen as the main site of recurrence. Primary fallopian tube carcinoma has a response to treatment and a tumour biology similar to that of ovarian carcinoma. It IS recommended that the management of this uncommon malignancy should continue to be along the lines of ovarian carcinoma, with initial treatment by cytoreductive surgery followed by chemotherapy or radiotherapy for residual disease. Primary fallopian tube carcinoma is an uncom- mon malignancy with a reported incidence between 0.3% and 1.6% of all gynaecological tumours (Raju zyxwvutsr at al. 1981). As a result of its rar- ity most reports from single institutions describe only a small numbcr of patients and thcrefore it is difficult to analyse the survival rates of patients according to stage and initial treatment. It has been usual in most centres to treat fall- opian tube carcinoma in thc same way as ovarian carcinoma. Surgery remains the mainstay of treatment and because ovarian malignancy is oftcn suspected preoperatively, the surgical approach is similar. Subsequent therapy has varied but appears to have made usc of those Cancer Research Campaign Department of Medical Oncology, Christie Hospital and Holt Radium Institute, Withington, Manchester, IIK H GURNEY Cbnrtul Research rello" D MURPHY Clinical Rewuich Fellow D CROWTHER Professor of Medical Oncologs Correspondence Dr D Murphy 822 treatments available for ovarian carcinoma at the time of diagnosis and has usually involved pelvic or abdominal radiotherapy, single alkylat- ing agent therapy or, more rcccntly, platinum based combination chemotherapy. This report summarizes experience in treating fallopiati tube carcinoma at our institution over the past 22 years, and specifically examines whether the policy of treating this tumour in the same way as ovarian carcinoma is sound. Tum- our extent at diagnosis, response to treatment? pattern of relapse and overall survival are exam- ined and compared with the known clinico-path- ological picture of ovarian cancer. Subjects and methods AU primary fallopian tube carcinomas referred to this institution over the previous 22 years were identified from computer records and the medical records were examined. For all tum- ours, the pathology was reviewed by a panel of pathologists specializing in gynaecological tum-