Pulmonary metastasectomy for uterine cervical cancer: A multivariate analysis
Pulmonary metastasectomy for uterine cervical cancer: A multivariate analysis
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DOI：
10.1016/j.athoracsur.2003.06.023
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发表时间：
2004-04-01
影响因子：
4.6
通讯作者：
Kamura, T
中科院分区：
文献类型：
--
作者：
Yamamoto, K;Yoshikawa, H;Kamura, T
背景。本研究评估了宫颈癌肺转移瘤切除的结果。方法。共有 7,748 名原发性 Ib 或 II 期宫颈癌患者在 22 家医院接受了包括根治性子宫切除术或放射治疗在内的治愈性初步治疗。在7,748名患者中，29名（0.37%）患者出现肺转移，这些患者在初始治疗（根治性子宫切除术或放射治疗）后无病期后被检测到，并于1998年6月30日进行切除以期治愈。结果。所有患者肺转移瘤切除术后5年无病生存率为32.9%。患有一处或两处肺转移的患者的 5 年无病生存率为 42.2%，而患有三处或四处转移的患者的 5 年无病生存率为 0% (p = 0.0003)。鳞状细胞癌患者的 5 年无病生存率为 47.4%，而腺鳞细胞癌或腺癌患者的 5 年无病生存率为 0% (p = 0.0141)。在多变量分析中，无病生存的重要预后变量是两个或更少的转移瘤（p = 0.0232）和鳞状细胞癌（p = 0.0168）。结论。当有两个或更少的转移瘤被诊断为鳞状细胞癌时，经过初步治疗（根治性子宫切除术或放射治疗）后出现肺转移的宫颈癌患者可以通过肺转移瘤切除术实现长期无病生存。
Background. This study evaluated the results of resection of pulmonary metastases from cervical cancer.Methods. A total of 7,748 patients with primary stage Ib or II cervical cancer underwent curative initial treatment consisting of radical hysterectomy or radiotherapy in 22 hospitals. Of the 7,748 patients, 29 (0.37%) patients had pulmonary metastases, which were detected after a disease-free period after initial treatment (radical hysterectomy or radiotherapy) and were resected with the intention to cure by June 30, 1998.Results. The 5-year disease-free survival rate after pulmonary metastasectomy for all patients was 32.9%. Patients with one or two pulmonary metastases had a 5-year disease-free survival rate of 42.2% compared with 0% for patients with three or four metastases (p = 0.0003). Patients with squamous cell cancers had a 5-year disease-free survival rate of 47.4% compared with 0% for patients with adenosquamous cell cancers or adenocarcinoma (p = 0.0141). On multivariate analysis, the significant prognostic variables for disease-free survival were two or fewer metastases (p = 0.0232) and squamous cell cancer (p = 0.0168).Conclusions. Cervical cancer patients with pulmonary metastases after initial treatment (radical hysterectomy or radiotherapy) could expect to achieve long-term disease-free survival by pulmonary metastasectomy when there are two or fewer metastases diagnosed as squamous cell cancer.