Surgical treatment of pulmonary metastases from uterine cervical cancer

Role of [18F]fluoro-2-deoxy-D-glucose positron emission tomography in re-recurrent cervical cancer

“…Vaginal alone after radical surgery and local recurrence confined to cervix after definitive radiotherapy or isolated para-aortic LN metastasis were associated with better outcome. Selected patients who had a distant relapse at sole site could be successfully salvaged by targeted chemoradiation, surgery plus radiotherapy, or surgery alone (2)(3)(4)(5)(6)(7)(15)(16)(17)(18)(19)(20) . Little is known about the outcome and prognostic factors for re-recurrent cervical cancer patients.…”

“…Our definitions of ''potentially curable'' for re-recurrent cervical cancer were modified from those for the first recurrence: (1) if radiotherapy (RT) had been given to the pelvis, the disease should be confined to central pelvis without pelvic sidewall or extrapelvic involvement; (2) distant recurrences that could be completely resected or encompassed by a curative RT procedure, such as para-aortic, supraclavicular, or inguinal LNs should be less than or equal to two sites; or (3) pulmonary metastasis, solitary or multiple (less than four nodules) but confined to one lobe, which could be completely excised or irradiated or solitary hepatic metastasis for which complete resection or radiofrequency ablation could be performed (11,(18)(19)(20) .…”

Surgical treatment of lung metastases: Prognostic factors for long-term survival

“…Another remarkable fact is that these results did not deteriorate when the indications for surgical resection were progressively broadened in terms of the number of metastases resected [21,22], the DFI between the treatment of the primary tumor and the diagnosis of lung metastases [7,[22][23][24][25], bilaterality [7,21,26], type of lung resection [27], and repeated thoracotomies for resection of recurrent pulmonary metastases, as far as complete resection is achievable [15,21,24,26,28,29]. This is true for a very heterogeneous group of tumors, with very different biological characteristics and clinical aggressiveness as can be perceived by review of the published literature, either in a series with metastases of different primary tumors, as the present one [2][3][4][5]7,26,30], or in a series of lung resections for metastases of a single type of primary tumor [8,12,14,15,[18][19][20][22][23][24][25][31][32][33][34][35][36][37][38]…”

“…The prognostic implication of the presence of lymph node metastases in the mediastinum is a very controversial issue [24][25][26]34] and one that is not easy to solve. To our knowledge there are no published series of lung resections for metastases with systematic mediastinal lymphadenectomy.…”

Indications and approach to surgical resection of lung metastases

“…Clavero et al [81] reported that both a short disease-free interval of less than 24 months and primary cervical uterine cancer had a negative influence on survival. Seki et al [82] reported that the overall 5-year survival after pulmonary metastasectomy from cervical squamous cell carcinoma was 52%. They found that pulmonary metastatic lesions 3 cm in diameter or larger were frequently accompanied by thoracic lymph node involvement and consequently related to a poor prognosis.…”