Pulmonary metastasectomy in uterine malignancy: outcomes and prognostic factors / 부인종양

OBJECTIVE: The aim of this study was to investigate outcomes in uterine cancer patients undergoing pulmonary metastasectomy and prognostic factors associated with survival after the procedure. METHODS: A retrospective study was performed in 29 uterine cancer patients who underwent surgical resection of pulmonary metastatic lesions at Samsung Medical Center between June 1995 and December 2011. RESULTS: Histopathology showed carcinoma in 17 patients (58.6%) and sarcoma in 12 patients (41.4%). Of the 29 patients, 17 (58.6%) had less than three pulmonary metastatic lesions. Eight (27.6%) had symptoms related to lung metastasis. The 5-year survival rate after pulmonary metastasectomy for the entire cohort was 48.2%. On univariate and multivariate analysis, the presence of pulmonary symptoms and more than three lesions of metastasis were associated with poor survival after pulmonary metastasectomy. CONCLUSION: Pulmonary metastasectomy for uterine cancer is an acceptable treatment in selected patients. Patients with more than three pulmonary metastatic lesions and pulmonary symptoms related to lung metastasis could expect to have worse prognosis after pulmonary metastasectomy.

A clinicopathologic analysis of 88 lung resections of suspected metastatic carcinomas with proven primaries.

Background: The lung is the most common site for metastatic carcinomas. Very few studies have comprehensively analyzed all pulmonary resections for metastatic carcinomas. Aims and Objectives: To analyze all lung resections for suspected metastatic carcinomas accrued over 10 years to evaluate: The most frequent primary site, The interval between primary tumor diagnosis and lung metastases, and The proportion of inadvertently resected benign lesions, clinicoradiologically mistakenfor metastatic deposits. Materials and Methods: Between 2002 and 2011, 88 pulmonary metastasectomies were done for suspected metastatic carcinomas, which form the basis of this study. Results: In 81 of 88 cases (92%) the diagnosis of metastatic carcinoma was histologically confirmed, whereas 7 cases (8%) were non-neoplastic. The mean interval between primary tumor and metastases was 2.5 years. The primary sites were colorectum (30; 37%), kidney and breast (14; 17.3% each), cervix (9; 10%), salivary gland carcinoma (3), thyroid carcinoma (2), squamous carcinoma (2, one each of mandible and larynx), papillary urothelial carcinoma (2), hepatocellular carcinoma (1), endometrioid adenocarcinoma (1), carcinosarcoma of endometrium (1), adrenocortical carcinoma (1), and neuroendocrine carcinoma (1). The 7 non-neoplastic lesions (8%) histologically revealed tuberculosis (4), bronchopneumonia (2), and aspergillosis (1). Conclusions: Almost three fourths (71.6%) of the metastatic pulmonary resections comprised primaries from colorectum, breast and kidney. The interval between primary tumor and metastases ranged from zero months to 10 years (mean 2.5 years). Tuberculosis was the most common histologic diagnosis among the 8% of the non-neoplastic lesions, which were mistaken for metastatic carcinoma on clinical evaluation.

Metastasectomía pulmonar: experiencia de once años / Lung metastasectomy: experience of eleven years

INTRODUCCIÓN. Las metástasis pulmonares son frecuentes tanto en tumores primarios epiteliales como en los mesenquimatosos, y se explican por el hecho de que todo el gasto cardíaco transita por la circulación menor. La indicación quirúrgica es un problema de relación costo-beneficio y está condicionada entre otros aspectos por el intervalo libre de enfermedad, el estado general del paciente, el número de metástasis y el tipo de resección. El objetivo del presente estudio fue presentar nuestra experiencia y resultados con dicho tratamiento. MÉTODOS. Se realizó un estudio descriptivo transversal retrospectivo con 6 pacientes con metástasis en pulmón, tratados en el Hospital Amalia Simoni, de Camagüey, entre 1997 y 2007. Las variables analizadas fueron sexo, edad, histopatología y localización del tumor primario, operación inicial, tiempo transcurrido entre la operación inicial y la metastasectomía, número de metástasis pre y transoperatorias, vía de abordaje, localización de los nódulos, tipo de resección quirúrgica y supervivencia. RESULTADOS. La media de edad fue de 56 años y no hubo diferencias en cuanto al sexo. En tres pacientes las tumoraciones primarias dependían del sistema digestivo, la mayoría fueron nódulos únicos y la lobectomía pulmonar fue el procedimiento más utilizado. La supervivencia promedio fue de 13 meses. No hubo morbilidad importante, ni fallecidos en la serie(AU)

INTRODUCTION. Lung metastases are frequent both in primary epithelial tumors and mesenchymatous tumors due to the fact that the whole cardiac output passes through the minor circulation. The surgical indication is a problem of cost-benefit relationship, and it is conditioned among other aspects by the disease free interval, the general state of the patient, the number of metastases and the type of resection. The objective of this study was to present our experience and results with this treatment. METHODS. A descriptive cross-sectional retrospective study was conducted in 6 patients with lung metastasis treated at Amalia Simoni Hospital in Camaguey between 1997 and 2007. The variables analyzed were sex, age, histopathology and localization of the primary tumor, initial operation, time elapsed between the initial operation and metastasectomy, number of pre- and transoperative metastases, approach route, localization of the nodules, type of surgical resection and survival. RESULTS. Average age was 56 years old and there was no difference as regards sex. The primary tumors depended on the digestive system in 3 patients. Most of them were unique nodules and pulmonary lobectomy was the most used procedure. Average survival was 13 months. No important morbidity was reported and there were no deaths in the series(AU)

Resultados y enfoque de la metastasectomía pulmonar en el Instituto Nacional de Oncología y Radiobiología de Cuba / Results and approach of lung metastasectomy in the National Institute of Oncology and Radiobiology of Cuba

El objetivo de esta presentación fue identificar los factores pronósticos relacionados con mayor supervivencia tras la metastasectomía pulmonar, para todo tipo de tumor primario, practicada en el Instituto Nacional de Oncología y Radiobiología de Cuba. . El intervalo libre de enfermedad fue identificado como el factor más importante para el pronóstico. El análisis de supervivencia nos permitió estratificar a los pacientes en grupos de riesgo según la progresión del tumor y sobre la base del tamaño y número de las lesiones y del intervalo libre de la enfermedad tras la escisión del tumor primario(AU)

The aim of this paper was to identify the prognostic factors related to higher survival after lung metastasectomy for all types of primary tumor performed in the National Institute of Oncology and Radiobiology of Cuba. The disease free interval was identified as the most important factor for prognosis. The survival analysis permitted to stratify the patients into risk groups according to the progression of the tumor and on the basis of the size and amount of lesions and of the disease free interval after the excision of the primary tumor(AU)