[Evaluation of surgical resection of pulmonary metastasis of trophoblastic tumour].
OBJECTIVE
To evaluate the role of lung lobectomy in the patients of tumor with lung metastases.


METHODS
A total of 45 cases of trophoblastic tumor with pulmonary metastases treated by lung lobectomy from 1985-2002 at PUMC hospital was retrospectively analyzed. Seven cases were diagnosed as invasive mole and thirty-eight as choriocarcinoma.


RESULTS
Lung lobectomy was performed in all of these patients after several courses of chemotherapy. Seven cases of invasive mole reached complete remission. Eleven cases of choriocarcinoma with stage IIIa had received average 13 courses of chemotherapy, 10 of them reached complete remission. Seventeen cases of choriocarcinoma with stage IIIb had received average 14.3 courses of chemotherapy, 11 of them reached complete remission. Ten cases of choriocarcinoma with stage IV had received average 15 courses of chemotherapy, six of them reached complete remission. In the 45 patients, histologic examination disclosed haemorrhagic necrotic tissue in 27 patients, 17 of them reached complete remission (63%). Histologic examination also revealed fibrosis around the focus in 16 patients, 14 of them reached complete remission (88%). Tuberculosis was found in 2 patients.


CONCLUSIONS
Although the development of effective chemotherapy has resulted in improved survival of patients with gestational trophoblastic tumor, lung lobectomy remains an important adjunct treatment in a selected subset of patients. Pathological examinations can help to estimate the prognosis.
Ren
Tong
T
Department of Obstetrics and Gynecology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.
Xiang
Yang
Y
Yang
Xiu-yu
XY
Wan
Xi-run
XR
Zhang
Zhi-yong
ZY
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D002822:Choriocarcinoma / Q000556:secondary / Q000601:surgery; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003609:Dactinomycin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D002820:Hydatidiform Mole, Invasive / Q000473:pathology / Q000556:secondary / Q000601:surgery; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D014328:Trophoblastic Neoplasms / Q000556:secondary / Q000601:surgery*; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery*; D014750:Vincristine / Q000008:administration & dosage
D003609:Dactinomycin; D014750:Vincristine; D005047:Etoposide; D003520:Cyclophosphamide; D008727:Methotrexate