Primary fallopian tube cancer (PFTC) is a rare tumor (< 1% of all female genital tract cancers) and remains poorly characterized. Histologically and clinically, PFTC resembles epithelial ovarian cancer (EOC). The similarities in pathological features and patterns of spread between EOC and PFTC have led clinicians to treat these two malignancies in a similar manner. However, these malignancies may be biologically distinct and may follow different clinical courses. Lymphadenectomy is of crucial importance in patients with EOC, because it improves disease-free survival even in advanced stages. The lymph node metastasis is relatively frequent even in early-stage PFTC. We therefore hypothesized that lymphadenectomy could improve the prognosis in PFTC, as observed in EOC. The purpose of this study is to evaluate the prognostic role of lymphadenectomy in PFTC with a special focus on advanced-stage PFTC. The medical records of 18 patients treated in a single institute from April 1997 to August 2004 were reviewed retrospectively. For advanced stages (III and IV, 10 patients), mean overall survival for patients with positive lymph node involvement is 62.00 ± 4.00 months, while the patients with negative lymph node involvement were alive at last follow-up performed in July 2008 (log-rank; P < 0.05). Furthermore, the mean disease-free survival for patients with positive lymph node involvement is 46.67 ± 5.14 months. Based on our analysis, lymphadenectomy could improve overall survival and disease-free survival in patients with advanced-stage PFTC.