Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi, Osaka, Japan.
Department of General Thoracic Surgery, Osaka International Cancer Institute, Osaka, Japan.
Ann Surg Oncol. 2020 Oct;27(10):3821-3828. doi: 10.1245/s10434-020-08426-5. Epub 2020 Apr 9.
Information on pulmonary metastasectomy (PM) for uterine malignancies in the current era is limited. In the present study, we analyzed the clinical course and results of PM for uterine malignancies in the era of modern imaging diagnostics to clarify the role of PM in the current era in a multi-institutional setting.
Fifty-seven patients who underwent PM for uterine malignancies between 2006 and 2015 were retrospectively reviewed. The short- and long-term outcomes, along with factors associated with the prognosis, were analyzed. Details of the clinical course after PM were described.
The mean age of patients was 59.4 years. The primary tumor was located in the uterus corpus in 34 cases (60%) and in the uterus cervix in 23 cases (40%). The median disease-free interval (DFI) was 32 months. Forty patients (70%) received fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography before PM, and complete resection was achieved in 52 patients (91%). Postoperative complications occurred in 4 patients (7%). Of the 52 patients who underwent complete resection of pulmonary metastases, 28 experienced recurrence, and among these, 17 (60%) underwent local therapy, including six repeat PMs. Among the 52 patients who underwent complete resection, the 5-year relapse-free survival rate was 40.7% and the 5-year overall survival (OS) rate was 68.8%. The univariate analysis revealed that a DFI of ≤ 24 months was associated with significantly poorer OS.
PM for uterine malignancies is safe and provides favorable long-term outcomes in selected patients. Patients with a DFI of > 24 months have better OS and are good candidates for PM.
目前关于现代影像学诊断时代子宫恶性肿瘤的肺转移瘤切除术（PM）的信息有限。在本研究中，我们分析了现代影像学诊断时代子宫恶性肿瘤的 PM 临床过程和结果，以明确在多机构环境中 PM 在当前时代的作用。
回顾性分析了 2006 年至 2015 年间接受子宫恶性肿瘤 PM 的 57 例患者。分析了短期和长期结果，以及与预后相关的因素。描述了 PM 后的临床过程的细节。
患者的平均年龄为 59.4 岁。原发肿瘤位于子宫体 34 例（60%），子宫颈 23 例（40%）。无疾病间隔（DFI）中位数为 32 个月。40 例（70%）患者在 PM 前接受氟-18-2-氟-2-脱氧-D-葡萄糖正电子发射断层扫描/计算机断层扫描，52 例（91%）患者达到完全切除。4 例（7%）患者术后出现并发症。在 52 例完全切除肺转移瘤的患者中，28 例复发，其中 17 例（60%）接受局部治疗，包括 6 例重复 PM。在 52 例完全切除的患者中，5 年无复发生存率为 40.7%，5 年总生存率（OS）为 68.8%。单因素分析显示，DFI≤24 个月与 OS 显著较差相关。
PM 治疗子宫恶性肿瘤是安全的，并为选定的患者提供良好的长期结果。DFI>24 个月的患者具有更好的 OS，是 PM 的良好候选者。
