title: Surgical management of lung, liver and brain metastases from gynecological cancers: a literature review.
abstract: BACKGROUND
  The management of patients with recurrent gynecological malignancy is complex, and often contentious. While historically, patients with metastases in the lungs, liver or brain have been treated with palliative intent, surgery is proving to have an increasing role in the management of such patients.
  
  
  METHODS
  In this review article, the surgical management of lung, liver and brain metastases from gynecological cancers is examined. A search of the English language literature over the last 25 years was conducted using the Medline and PubMed databases.
  
  
  RESULTS
  The results for management of metastases from the endometrium, ovary and cervix to the lung, brain and liver show that surprisingly good long-term survival results can be achieved for resection of metastases from all three organs. Patient selection is critical, and surgery is often used in conjunction with other treatment modalities.
  
  
  CONCLUSIONS
  From this review, it is apparent that surgery should play an increasing role in the management of patients with parenchymal metastases from gynecological cancers. The surgery should ideally be performed in high volume, tertiary centers where there is a committed multi-disciplinary team with the necessary infrastructure to achieve the best possible outcomes in terms of both survival and morbidity.
authors.affiliation: Gynaecological Cancer Centre, Royal Hospital for Women, Randwick, NSW 2031 Australia ; School of Women's and Children's Health, University of New South Wales, Kensington, NSW 2052 Australia.
authors.forename: Neville F
authors.initials: NF
authors.lastname: Hacker
authors.affiliation: Gynaecological Cancer Centre, Royal Hospital for Women, Randwick, NSW 2031 Australia ; School of Women's and Children's Health, University of New South Wales, Kensington, NSW 2052 Australia.
authors.forename: Archana
authors.initials: A
authors.lastname: Rao
keywords: Brain; Cervix; Endometrium; Gynecological malignancy; Liver; Lung; Metastasis; Ovary; Survival