title: Pulmonary metastases from uterine malignancies: results of surgical resection in 133 patients.
abstract: 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 (> or =4), and large tumor size (> or =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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Thoracic Surgery, Tochigi Cancer Center, Utsunomiya, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Anraku
authors.forename: Kohei
authors.initials: K
authors.lastname: Yokoi
authors.forename: Ken
authors.initials: K
authors.lastname: Nakagawa
authors.forename: Takehiko
authors.initials: T
authors.lastname: Fujisawa
authors.forename: Jun
authors.initials: J
authors.lastname: Nakajima
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Akiyama
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nishimura
authors.forename: Koichi
authors.initials: K
authors.lastname: Kobayashi
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000556:secondary* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D015999:Multivariate Analysis; D016609:Neoplasms, Second Primary / Q000473:pathology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D016019:Survival Analysis; D013908:Thoracotomy; D013997:Time Factors; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000473:pathology* / Q000601:surgery; D016387:Women's Health