Pathologic diagnosis and resection of suspicious thoracic metastases in patients with cervical cancer through thoracotomy or video-assisted thoracic surgery.
OBJECTIVE
The purpose of this study was to clarify the role of resection for suspicious thoracic metastasis in cervical cancer patients with thoracotomy or video-assisted thoracic surgery (VATS).


METHODS
A retrospective study was performed involving patients with primary and recurrent cervical cancer who underwent surgical resections for suspicious thoracic metastatic lesions at a single academic institution between January 2003 and February 2009.


RESULTS
Twenty-three pulmonary resections were performed on 21 patients via thoracotomies (n=10), VATS (n=11), and thoracotomies following VATS (n=2). All suspicious pulmonary lesions were completely resected in all 3 surgical groups. A total of 49 surgical procedures were performed, as follows: 25 wedge resections, 9 lobectomies, 12 mediastinal lymph node dissections, 1 segmentectomy, 1 diaphragmatic resection, and 1 pleurectomy. The pathologic evaluation revealed metastasis from cervical cancer, primary lung cancer, no pathologic abnormality, and tuberculosis in 14, 7, 2, and 1 of the surgical specimens, respectively; 1 patient had primary lung cancer and mediastinal lymph node metastasis from cervical cancer. Different pathologic diagnoses were rendered in 6 patients compared to the image-based diagnoses. After pulmonary metastasectomy, 2 patients died from the disease, 3 patients were alive with disease, and 16 patients were alive without disease, with a median follow-up of 16 months (range, 2-67 months).


CONCLUSIONS
Resection of suspicious thoracic metastasis with thoracotomy or VATS permits accurate pathologic diagnosis and favorable curative resection in selected patients with cervical cancer.
Lim
Myong Cheol
MC
Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Gyeonggi-do, Korea. mclim@ncc.re.kr
Lee
Hyun-Sung
HS
Seo
Sang-Soo
SS
Kim
Moon Soo
MS
Kim
Joo-Young
JY
Zo
Jae Ill
JI
Park
Sang Yoon
SY
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*