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J Thorac Cardiovasc Surg 2004;127:1107-1112
© 2004 The American Association for Thoracic Surgery

General thoracic surgery

Pulmonary metastases from uterine malignancies: Results of surgical resection in 133 patients

^a Division of Thoracic Surgery, Tochigi Cancer Center, Tochigi, Japan
^b Department of Chest Surgery, Cancer Institute Hospital, Tokyo, Japan
^c Department of Thoracic Surgery, Chiba University, Chiba, Japan
^d Department of Cardiothoracic Surgery, University of Tokyo, Tokyo, Japan
^e Department of Thoracic Surgery, Saitama Cancer Center, Saitama, Japan
^f Department of Surgery, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
^g Department of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan

Received for publication May 20, 2003; revisions received September 28, 2003; accepted for publication October 6, 2003.

^* Address for reprints: Kohei Yokoi, MD, Tochigi Cancer Center, Division of Thoracic Surgery, 4-9-13 Yohnan, Utsunomiya, Tochigi 320-0834, Japan
kyokoi{at}tcc.pref.tochigi.jp

OBJECTIVE: The long-term results of the surgical treatment for patients with pulmonary metastases from uterine malignancies were clarified.

METHODS: A total of 133 patients who underwent pulmonary metastasectomy for uterine malignancies were enrolled in the Metastatic Lung Tumor Study Group of Japan between March 1984 and February 2002. These patients constituted the study population, and their clinical, pathologic, and prognostic data were retrospectively analyzed.

RESULTS: The morbidity and mortality rates related to the operation were minimal (1% and 1%, respectively). The 5- and 10-year survivals after the surgical resection in all cases were 54.6% and 44.9%, respectively. The 5-year survivals for each histologic type were estimated to be 46.8% for squamous cell carcinoma (n = 58), 40.3% for cervical adenocarcinoma (n = 13), 75.7% for endometrial adenocarcinoma (n = 23), 86.5% for choriocarcinoma (n = 16), and 37.9% for leiomyosarcoma (n = 11). In the univariate analysis, the following were shown to be associated with poor survival: primary tumor in the cervix, short disease-free interval (<12 months), large number of resected metastases (4), and large tumor size (3 cm). After mutual adjustment, short disease-free interval (<12 months) alone was related to risk of death (hazard ratio = 2.26, 95% confidence interval = 1.06-4.78) for 105 patients, excluding patients with choriocarcinoma and miscellaneous histologic types.

CONCLUSION: Pulmonary metastasectomy for uterine malignancies is a safe and acceptable treatment to improve survival. Patients with a disease-free interval of 12 months or more are good candidates for this treatment if there is adequate control of the primary tumor without extrapulmonary metastasis.

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