Department of Obstetrics and Gynecology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Taiwan J Obstet Gynecol. 2022 Mar;61(2):333-338. doi: 10.1016/j.tjog.2022.02.024.
Pulmonary lymphangitic carcinomatosis (PLC) is a rare event of metastatic lung disease in advanced gynecologic malignancy. Nonspecific symptoms of patients and difficulties in detection of PLC often result in a delayed diagnosis. In this study, we evaluated the clinical outcomes of PLC in patients with gynecologic cancer.
We retrospectively reviewed electronic medical records of patients with gynecologic cancer who received care from January 1, 2008 through December 31, 2018 in Samsung Medical Center, Seoul, Republic of Korea. We based diagnosis of PLC on chest CT scan and analyzed clinical parameters of cancer type, International Federation of Gynecology and Obstetrics (FIGO) stage, histology, and patient survival.
During the study period, 27 cases of PLC in patients with gynecologic malignancy were identified, including 11 cervical, 12 ovarian, and four uterine cancers. The most common histologic type at initial diagnosis was squamous cell in cervical (6/11, 55%), serous in ovarian (1/11, 92%), and serous in endometrial (2/4, 50%) cancer. The average survival time from diagnosis of PLC to death was a mean of 5.7 months (0.7-23.6 months) in all patients and 6.3, 6.6, and 3.6 months for cervical, endometrial, and ovarian cancer, respectively.
This study showed that PLC results in extremely poor survival, from several days to a few months, in patients with gynecologic cancer. Clinicians must be aware of these clinical characteristics and consider other novel therapeutic strategies in the future.
肺淋巴管癌病(PLC)是晚期妇科恶性肿瘤中一种罕见的肺部转移疾病。患者的非特异性症状和 PLC 检测困难常常导致诊断延误。本研究评估了妇科癌症患者 PLC 的临床结局。
我们回顾性分析了 2008 年 1 月 1 日至 2018 年 12 月 31 日期间在韩国首尔三星医疗中心接受治疗的妇科癌症患者的电子病历。我们基于胸部 CT 扫描诊断 PLC,并分析了癌症类型、国际妇产科联盟(FIGO)分期、组织学和患者生存的临床参数。
在研究期间,我们确定了 27 例妇科恶性肿瘤合并 PLC 的患者,包括 11 例宫颈癌、12 例卵巢癌和 4 例子宫内膜癌。初始诊断时最常见的组织学类型为宫颈癌中的鳞状细胞癌(6/11,55%)、卵巢癌中的浆液性癌(1/11,92%)和子宫内膜癌中的浆液性癌(2/4,50%)。所有患者从 PLC 诊断到死亡的平均生存时间为 5.7 个月(0.7-23.6 个月),宫颈癌、子宫内膜癌和卵巢癌的平均生存时间分别为 6.3、6.6 和 3.6 个月。
本研究表明,PLC 导致妇科癌症患者的生存极差,从数天到数月不等。临床医生必须了解这些临床特征,并考虑未来的其他新型治疗策略。