Kanzaki Ryu, Okami Jiro, Takami Koji, Iwasaki Teruo, Ikeda Naoki, Funakoshi Yasunobu, Sakamaki Yasushi, Kodama Ken, Yokouchi Hideoki, Kadota Yoshihisa, Ose Naoko, Shintani Yasushi
Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2 (L5), Yamadaoka, Suita, 565-0871, Japan.
Department of General Thoracic Surgery, Osaka International Cancer Institute, Osaka, Japan.
J Cardiothorac Surg. 2020 Jul 23;15(1):182. doi: 10.1186/s13019-020-01231-x.
Due to its rarity, information on pulmonary metastasectomy for pulmonary metastasis from ovarian cancer is limited.
Cases of pulmonary metastasectomy for ovarian cancer were collected in a multi-institutional setting and the outcomes were analyzed.
Among 1508 cases in which pulmonary resection was performed to treat pulmonary metastasis from tumors of various organs, 6 cases (0.4%) involved pulmonary metastasis from ovarian cancer. The mean age was 61 years (range, 39-75 years). The histological types were undifferentiated carcinoma in 2 patients, and clear cell adenocarcinoma, serous papillary cystadenocarcinoma, serous adenocarcinoma, and endometroid adenocarcinoma in 1 patient each. One patient (17%) had a history of liver metastasis at the time of pulmonary resection. The median disease-free interval was 22 months (range, 0 [synchronous]-188 months). The tumor was solitary in 5 patients (83%). The mean tumor size was 15 mm (range, 5-23 mm). All 6 patients underwent complete resection. The type of resection was wide wedge resection in 3 patients, segmentectomy in 2 patients, and lobectomy in 1 patient. Four patients (67%) received postoperative chemotherapy. Thus far, 4 patients (67%) have experienced recurrence after pulmonary resection. In terms of outcomes, 1 patient who had synchronous pulmonary metastasis with the primary tumor died in the early period after pulmonary resection, 1 patient is alive without recurrence after a short follow-up period (5 months), 3 patients have achieved mid- to long-term survival and are alive with disease (38-61 months), and 1 patient achieved long-term (61 months) disease-free survival.
Patients with pulmonary metastasis from ovarian cancer who fulfill the eligibility criteria for pulmonary metastasectomy are rare. Pulmonary metastasectomy for ovarian cancer can provide favorable outcomes in highly selected patients. Patients with synchronous pulmonary metastasis from ovarian cancer are not good candidates for pulmonary metastasectomy.
由于其罕见性，关于卵巢癌肺转移行肺转移瘤切除术的信息有限。
在多机构环境中收集卵巢癌肺转移瘤切除术的病例并分析其结果。
在1508例行肺切除术治疗各种器官肿瘤肺转移的病例中，6例（0.4%）为卵巢癌肺转移。平均年龄为61岁（范围39 - 75岁）。组织学类型为2例未分化癌，1例透明细胞腺癌、浆液性乳头状囊腺癌、浆液性腺癌和子宫内膜样腺癌各1例。1例患者（17%）在肺切除时已有肝转移史。无病间期的中位数为22个月（范围0[同时性] - 188个月）。5例患者（83%）肿瘤为孤立性。平均肿瘤大小为15毫米（范围5 - 23毫米）。所有6例患者均行根治性切除。切除方式为3例行广泛楔形切除术，2例行肺段切除术，1例行肺叶切除术。4例患者（67%）接受了术后化疗。迄今为止，4例患者（67%）在肺切除后出现复发。就结果而言，1例原发性肿瘤伴同时性肺转移的患者在肺切除后早期死亡，1例患者在短期随访期（5个月）后存活且无复发，3例患者实现了中长期生存且带瘤生存（38 - 61个月），1例患者实现了长期（61个月）无病生存。
符合肺转移瘤切除术适应证标准的卵巢癌肺转移患者罕见。卵巢癌肺转移瘤切除术在经过严格挑选的患者中可提供良好的结果。原发性肿瘤伴同时性肺转移的卵巢癌患者不是肺转移瘤切除术的合适候选者。
