Gynecologic Cancers: Factors Affecting Survival After Pulmonary Metastasectomy

Jose M. Clavero, Claude Deschamps, Stephen D. Cassivi, Mark S. Allen, Francis C. Nichols, Brigitte A. Barrette, Dirk R. Larson, Peter C. Pairolero

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Background: Little information is available regarding long-term survival after pulmonary metastasectomy for gynecologic malignancies. Methods: All patients who underwent pulmonary resection for gynecologic malignancies at our institution between January 1985 and June 2001 were reviewed. Factors affecting long-term survival were analyzed. Results: There were 103 patients, 70 of whom had metastatic disease limited to the lungs. Median age of these 70 patients was 59.4 years (range, 31 to 80 years). The primary tumor originated in the uterine corpus in 37 patients, endometrium in 23, cervix in 7, ovaries in 2, and vagina in 1. Histopathology was leiomyosarcoma in 29 patients, adenocarcinoma in 23, other sarcoma in 11, squamous cell carcinoma in 5, and choriocarcinoma and endolymphatic stromal myosis in 1 each. The median time interval between the first gynecologic procedure and pulmonary resection was 24 months (range, 0 to 237 months). A wedge excision was performed in 44 patients, lobectomy in 14, bilobectomy in 2, pneumonectomy in 1, and a combination in 9. Five patients (7%) had an incomplete resection. Eighteen patients (25.7%) developed at least one complication and 1 died (operative mortality, 1.4%). At last follow-up, 35 had died, and the median follow-up among those who were still alive was 36 months (range, 6 months to 13 years). Five-year and 10-year survival was 46.8% (95% confidence interval, 34.2% to 63.0%) and 34.3% (95% confidence interval, 19.7% to 52.5%), respectively. Factors that adversely affected survival include a disease-free interval between the first gynecologic procedure and pulmonary resection of less than 24 months (p = 0.004) and a primary site located in the cervix (p < 0.001). Conclusions: Pulmonary resection for metastatic gynecologic cancer in selected patients is safe and effective. Both a short disease-free interval between the primary gynecologic procedure and pulmonary metastasectomy, and a primary cervical tumor had an adverse effect on survival.

Original languageEnglish (US)
Pages (from-to)2004-2007
Number of pages4
JournalAnnals of Thoracic Surgery
Volume81
Issue number6
DOIs
StatePublished - Jun 2006
Externally publishedYes

Fingerprint

Metastasectomy
Lung
Survival
Neoplasms
Cervix Uteri
Endometrial Stromal Tumors
Confidence Intervals
Choriocarcinoma
Leiomyosarcoma
Pneumonectomy
Vagina
Endometrium
Sarcoma
Squamous Cell Carcinoma
Ovary
Adenocarcinoma

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Clavero, J. M., Deschamps, C., Cassivi, S. D., Allen, M. S., Nichols, F. C., Barrette, B. A., ... Pairolero, P. C. (2006). Gynecologic Cancers: Factors Affecting Survival After Pulmonary Metastasectomy. Annals of Thoracic Surgery, 81(6), 2004-2007. https://doi.org/10.1016/j.athoracsur.2006.01.068

Gynecologic Cancers : Factors Affecting Survival After Pulmonary Metastasectomy. / Clavero, Jose M.; Deschamps, Claude; Cassivi, Stephen D.; Allen, Mark S.; Nichols, Francis C.; Barrette, Brigitte A.; Larson, Dirk R.; Pairolero, Peter C.

In: Annals of Thoracic Surgery, Vol. 81, No. 6, 06.2006, p. 2004-2007.

Research output: Contribution to journalArticle

Clavero, JM, Deschamps, C, Cassivi, SD, Allen, MS, Nichols, FC, Barrette, BA, Larson, DR & Pairolero, PC 2006, 'Gynecologic Cancers: Factors Affecting Survival After Pulmonary Metastasectomy', Annals of Thoracic Surgery, vol. 81, no. 6, pp. 2004-2007. https://doi.org/10.1016/j.athoracsur.2006.01.068
Clavero JM, Deschamps C, Cassivi SD, Allen MS, Nichols FC, Barrette BA et al. Gynecologic Cancers: Factors Affecting Survival After Pulmonary Metastasectomy. Annals of Thoracic Surgery. 2006 Jun;81(6):2004-2007. https://doi.org/10.1016/j.athoracsur.2006.01.068
Clavero, Jose M. ; Deschamps, Claude ; Cassivi, Stephen D. ; Allen, Mark S. ; Nichols, Francis C. ; Barrette, Brigitte A. ; Larson, Dirk R. ; Pairolero, Peter C. / Gynecologic Cancers : Factors Affecting Survival After Pulmonary Metastasectomy. In: Annals of Thoracic Surgery. 2006 ; Vol. 81, No. 6. pp. 2004-2007.
@article{ce2861e3e75e4a98bf4ae430a528a0a2,
title = "Gynecologic Cancers: Factors Affecting Survival After Pulmonary Metastasectomy",
abstract = "Background: Little information is available regarding long-term survival after pulmonary metastasectomy for gynecologic malignancies. Methods: All patients who underwent pulmonary resection for gynecologic malignancies at our institution between January 1985 and June 2001 were reviewed. Factors affecting long-term survival were analyzed. Results: There were 103 patients, 70 of whom had metastatic disease limited to the lungs. Median age of these 70 patients was 59.4 years (range, 31 to 80 years). The primary tumor originated in the uterine corpus in 37 patients, endometrium in 23, cervix in 7, ovaries in 2, and vagina in 1. Histopathology was leiomyosarcoma in 29 patients, adenocarcinoma in 23, other sarcoma in 11, squamous cell carcinoma in 5, and choriocarcinoma and endolymphatic stromal myosis in 1 each. The median time interval between the first gynecologic procedure and pulmonary resection was 24 months (range, 0 to 237 months). A wedge excision was performed in 44 patients, lobectomy in 14, bilobectomy in 2, pneumonectomy in 1, and a combination in 9. Five patients (7{\%}) had an incomplete resection. Eighteen patients (25.7{\%}) developed at least one complication and 1 died (operative mortality, 1.4{\%}). At last follow-up, 35 had died, and the median follow-up among those who were still alive was 36 months (range, 6 months to 13 years). Five-year and 10-year survival was 46.8{\%} (95{\%} confidence interval, 34.2{\%} to 63.0{\%}) and 34.3{\%} (95{\%} confidence interval, 19.7{\%} to 52.5{\%}), respectively. Factors that adversely affected survival include a disease-free interval between the first gynecologic procedure and pulmonary resection of less than 24 months (p = 0.004) and a primary site located in the cervix (p < 0.001). Conclusions: Pulmonary resection for metastatic gynecologic cancer in selected patients is safe and effective. Both a short disease-free interval between the primary gynecologic procedure and pulmonary metastasectomy, and a primary cervical tumor had an adverse effect on survival.",
author = "Clavero, {Jose M.} and Claude Deschamps and Cassivi, {Stephen D.} and Allen, {Mark S.} and Nichols, {Francis C.} and Barrette, {Brigitte A.} and Larson, {Dirk R.} and Pairolero, {Peter C.}",
year = "2006",
month = "6",
doi = "10.1016/j.athoracsur.2006.01.068",
language = "English (US)",
volume = "81",
pages = "2004--2007",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "6",

}

TY - JOUR

T1 - Gynecologic Cancers

T2 - Factors Affecting Survival After Pulmonary Metastasectomy

AU - Clavero, Jose M.

AU - Deschamps, Claude

AU - Cassivi, Stephen D.

AU - Allen, Mark S.

AU - Nichols, Francis C.

AU - Barrette, Brigitte A.

AU - Larson, Dirk R.

AU - Pairolero, Peter C.

PY - 2006/6

Y1 - 2006/6

N2 - Background: Little information is available regarding long-term survival after pulmonary metastasectomy for gynecologic malignancies. Methods: All patients who underwent pulmonary resection for gynecologic malignancies at our institution between January 1985 and June 2001 were reviewed. Factors affecting long-term survival were analyzed. Results: There were 103 patients, 70 of whom had metastatic disease limited to the lungs. Median age of these 70 patients was 59.4 years (range, 31 to 80 years). The primary tumor originated in the uterine corpus in 37 patients, endometrium in 23, cervix in 7, ovaries in 2, and vagina in 1. Histopathology was leiomyosarcoma in 29 patients, adenocarcinoma in 23, other sarcoma in 11, squamous cell carcinoma in 5, and choriocarcinoma and endolymphatic stromal myosis in 1 each. The median time interval between the first gynecologic procedure and pulmonary resection was 24 months (range, 0 to 237 months). A wedge excision was performed in 44 patients, lobectomy in 14, bilobectomy in 2, pneumonectomy in 1, and a combination in 9. Five patients (7%) had an incomplete resection. Eighteen patients (25.7%) developed at least one complication and 1 died (operative mortality, 1.4%). At last follow-up, 35 had died, and the median follow-up among those who were still alive was 36 months (range, 6 months to 13 years). Five-year and 10-year survival was 46.8% (95% confidence interval, 34.2% to 63.0%) and 34.3% (95% confidence interval, 19.7% to 52.5%), respectively. Factors that adversely affected survival include a disease-free interval between the first gynecologic procedure and pulmonary resection of less than 24 months (p = 0.004) and a primary site located in the cervix (p < 0.001). Conclusions: Pulmonary resection for metastatic gynecologic cancer in selected patients is safe and effective. Both a short disease-free interval between the primary gynecologic procedure and pulmonary metastasectomy, and a primary cervical tumor had an adverse effect on survival.

AB - Background: Little information is available regarding long-term survival after pulmonary metastasectomy for gynecologic malignancies. Methods: All patients who underwent pulmonary resection for gynecologic malignancies at our institution between January 1985 and June 2001 were reviewed. Factors affecting long-term survival were analyzed. Results: There were 103 patients, 70 of whom had metastatic disease limited to the lungs. Median age of these 70 patients was 59.4 years (range, 31 to 80 years). The primary tumor originated in the uterine corpus in 37 patients, endometrium in 23, cervix in 7, ovaries in 2, and vagina in 1. Histopathology was leiomyosarcoma in 29 patients, adenocarcinoma in 23, other sarcoma in 11, squamous cell carcinoma in 5, and choriocarcinoma and endolymphatic stromal myosis in 1 each. The median time interval between the first gynecologic procedure and pulmonary resection was 24 months (range, 0 to 237 months). A wedge excision was performed in 44 patients, lobectomy in 14, bilobectomy in 2, pneumonectomy in 1, and a combination in 9. Five patients (7%) had an incomplete resection. Eighteen patients (25.7%) developed at least one complication and 1 died (operative mortality, 1.4%). At last follow-up, 35 had died, and the median follow-up among those who were still alive was 36 months (range, 6 months to 13 years). Five-year and 10-year survival was 46.8% (95% confidence interval, 34.2% to 63.0%) and 34.3% (95% confidence interval, 19.7% to 52.5%), respectively. Factors that adversely affected survival include a disease-free interval between the first gynecologic procedure and pulmonary resection of less than 24 months (p = 0.004) and a primary site located in the cervix (p < 0.001). Conclusions: Pulmonary resection for metastatic gynecologic cancer in selected patients is safe and effective. Both a short disease-free interval between the primary gynecologic procedure and pulmonary metastasectomy, and a primary cervical tumor had an adverse effect on survival.

UR - http://www.scopus.com/inward/record.url?scp=33646853298&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33646853298&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2006.01.068

DO - 10.1016/j.athoracsur.2006.01.068

M3 - Article

C2 - 16731120

AN - SCOPUS:33646853298

VL - 81

SP - 2004

EP - 2007

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 6

ER -