Background: Uterine malignancies frequently metastasize to the lungs. Pulmonary metastasectomy has demonstrated survival benefits in some malignancies; however, its efficacy for uterine malignancies remains unclear. Methods: We retrospectively analyzed 38 patients who underwent pulmonary metastasectomy for uterine malignancies at the Kanagawa Cancer Center between 2010 and 2020. The primary endpoint was recurrence-free survival (RFS) after pulmonary resection. Results: The median patient age was 63 years. The primary sites were the cervical uteri (n= 22) and corpus uteri (n= 16). The FIGO stages at the time of treatment for the primary tumor were I, II, III, IV, and unknown in 20, 7, 9, 1, and 1 patient, respectively. The median disease-free interval (DFI), defined as the interval between primary treatment and first recurrence, was 26.5 months. Most patients had single metastasis (n= 32). The procedures for metastasectomy included lobectomy, segmentectomy, and wedge resection (n= 15, 8, and 15, respectively), and two cases resulted in microscopically incomplete resection. The median follow-up period after pulmonary metastasectomy was 57 months, with 16 patients experiencing recurrence after pulmonary metastasectomy (5-year RFS rate: 55.6%). Univariate analysis identified FIGO stage ≥ III, DFI < 12 months, presence of synchronous extrapulmonary recurrence, and uterine sarcoma as poor prognostic factors. No prognostic differences were found between cervical and corpus uteri cancers. Conclusions: Pulmonary metastasectomy may confer prognostic benefits in patients with uterine malignancies. Careful consideration is warranted for patients with advanced-stage primary tumors, early recurrence after primary treatment, synchronous extrapulmonary recurrence, and uterine sarcoma.
背景：子宫恶性肿瘤常发生肺转移。肺转移瘤切除术在某些恶性肿瘤中已显示出生存获益，但其对子宫恶性肿瘤的疗效尚不明确。方法：我们回顾性分析了2010年至2020年间在神奈川县癌症中心接受肺转移瘤切除术的38例子宫恶性肿瘤患者。主要终点为肺切除术后无复发生存期（RFS）。结果：患者中位年龄为63岁。原发部位为子宫颈（n=22）和子宫体（n=16）。原发肿瘤治疗时的FIGO分期分别为I期、II期、III期、IV期和未知，患者数分别为20例、7例、9例、1例和1例。中位无病间期（DFI，定义为初始治疗至首次复发的时间间隔）为26.5个月。大多数患者为单发转移（n=32）。转移瘤切除术式包括肺叶切除术、肺段切除术和楔形切除术（分别为15例、8例和15例），其中2例为显微镜下不完全切除。肺转移瘤切除术后的中位随访时间为57个月，16例患者在术后出现复发（5年RFS率：55.6%）。单因素分析显示，FIGO分期≥III期、DFI<12个月、同时性肺外复发以及子宫肉瘤是预后不良因素。子宫颈癌与子宫体癌之间未发现预后差异。结论：肺转移瘤切除术可能为子宫恶性肿瘤患者带来预后获益。对于原发肿瘤分期较晚、初始治疗后早期复发、存在同时性肺外复发以及子宫肉瘤患者，需谨慎评估手术指征。
肿瘤(癌症)患者之家