Pulmonary metastasis from endometrial carcinoma

Abstract

The objective of this article is to investigate the clinical features of pulmonary metastasis (PM) from endometrial adenocarcinoma, in particular, the predictors of prolonged survival after PM detection. Fifteen patients who developed PM and underwent chest computed tomography (CT) scans for evaluation of PM were studied: 12 patients with pulmonary recurrence and 3 patients with PM on presentation. All patients with bilateral nodules or lymphangitic spread had metastases in other sites prior to or concomitant with PM, most of which were detected in para-aortic lymph nodes and/or the vaginal wall, while only one of five patients with a limited number (n < or = 5) of unilateral nodules had these metastases. The median survival time for the 10 patients with bilateral PMs was significantly shorter than that of the 5 patients with a limited number of unilateral nodules who were treated with surgery (7 versus 50 months, P = 0.005). Patients who developed pulmonary recurrence 2 years after the initial therapy had a significantly longer survival than those who developed it within 2 years (31 versus 10 months, P = 0.01). In conclusion, the distribution of PM determined by CT scans and the time interval between the initial therapy and the detection of pulmonary recurrence are the predictors of survival after PM detection.

Lymphadenectomy and adjuvant therapy in endometrial carcinoma: role of adjuvant chemotherapy

“…Patients with paraaortic node involvement have been reported to have a worse 5-year survival rate than those with pelvic node metastasis alone: 27 -75% vs 67 -100%, respectively (Potish et al, 1985;Corn et al, 1992;Hicks et al, 1993;Kadar et al, 1994;Onda et al, 1997;Yokoyama et al, 1997). In our previous study, patients with paraaortic node metastases were at risk of pulmonary metastases (Otsuka et al, 2002); thus, a haematogenous spread such as pulmonary metastases developing after paraaortic node involvement may reduce the survival.…”

Hematogenous metastases in patients with Stage I or II endometrial carcinoma

“…In the literature, the survival rate for these patients is generally poor, with 1-year survival rates of 20-30% and 5-year survival rates of less than 10% [6,8,9,20,23,42,50].…”

Resección de metástasis pulmonares en cánceres ginecológicos: Presentación de un caso y análisis de la literatura

“…La primera resección de una metástasis pulmonar de un cáncer ginecológico fue realizada por Torek en 1930, en una paciente con un adenocarcinoma uterino 30 . Desde entonces se han realizado resecciones de metástasis pulmonares de diferentes cánceres ginecológicos con resultados similares a lo observado en otros tumores primarios 7,19,[26][27][28][31][32][33] .…”

“…En los estudios de pacientes sometidas a resección de metástasis pulmonares el intervalo libre de enfermedad luego de la resección ha sido de 21 a 29 meses, la sobrevida media de 15,7 a 81 meses y la sobrevida a cinco años de 57,2% a 75,7% 31,32,36 .…”

“…En los cánceres cérvico-uterinos, menos de 2 metástasis e histología escamosa se han asociado a un mayor intervalo libre de enfermedad 26,31 . Y en sarcomas uterinos la presencia de metástasis unilaterales se asoció a un mejor pronóstico y una resección incompleta fue factor de mal pronóstico 19,32 . En general, en los cánce-res ginecológicos los factores de mal pronóstico identificados son: un intervalo libre de enfermedad menor de 12 ó 24 meses, mayor número de metástasis pulmonares, metástasis de mayor tamaño y un cáncer primario cérvico-uterino 31,36 .…”