Abstract

 

OBJECTIVES

Lung metastases from gynaecological tract cancers are rare, and prognostic factors are still undefined. The goal of this study was to analyse prognostic factors for survival in this group of patients.

METHODS

Data of patients with lung metastases from gynaecological tract cancers who underwent surgical resections from 1 January 2005 to 31 May 2019 were reviewed retrospectively. All patients were treated surgically if the primitive tumour was under control and the lung was the only organ involved. Clinical and pathological data associated with metastatic patterns and previous treatment types were correlated with overall survival (OS) and disease-free survival using Kaplan–Meier curves, whereas the log-rank test was used to assess differences between subgroups.

RESULTS

The analysis was conducted on 55 patients. OS was 65% at 5 years. With univariable analysis, age >45 years (P = 0.022) and the absence of pleural infiltration (P = 0.001) were determined to be favourable prognostic factors. The 5-year OS was 69.9% versus 53.3% in patients with pleural involvement. Multivariable analysis confirmed the absence of pleural infiltration as a favourable independent prognostic factor; the hazard ratio was 0.06; the 95% confidence interval was 0.00–0.23 (P = 0.011).At univariable analysis, the absence of pleural infiltration was determined to be a favourable prognostic factor (P = 0.034) for disease-free survival. The numbers and dimensions of the metastases did not influence survival in these patients.In uterine cancers of endometrial or cervical origin, the presence of pleural infiltration (P = 0.001), lymph node involvement (P = 0.001) and young age (P = 0.044) were considered unfavourable prognostic factors for OS.

CONCLUSIONS

Surgical treatment in technically resectable gynaecological tract metastases may represent an important option. Pleural infiltration and lymph node metastases seem to be adverse prognostic factors.

中文翻译：

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妇科肿瘤肺转移患者生存的预后因素

摘要

 

目标

妇科癌症的肺转移很少见，预后因素仍不确定。本研究的目的是分析这组患者生存的预后因素。

方法

回顾性分析了 2005 年 1 月 1 日至 2019 年 5 月 31 日期间接受手术切除的妇科癌症肺转移患者的数据。如果原始肿瘤得到控制并且肺是唯一受累的器官，所有患者都接受了手术治疗。使用 Kaplan-Meier 曲线将与转移模式和先前治疗类型相关的临床和病理学数据与总生存期 (OS) 和无病生存期相关，而对数秩检验用于评估亚组之间的差异。

结果

对 55 名患者进行了分析。5 年时 OS 为 65%。通过单变量分析，年龄>45 岁（P  = 0.022）和无胸膜浸润（P  = 0.001）被确定为有利的预后因素。5 年 OS 为 69.9%，而胸膜受累患者为 53.3%。多变量分析证实没有胸膜浸润是有利的独立预后因素；风险比为 0.06；95% 置信区间为 0.00-0.23 ( P  = 0.011)。在单变量分析中，无胸膜浸润被确定为有利的预后因素 ( P = 0.034) 无病生存。转移的数量和大小不影响这些患者的生存。在子宫内膜或宫颈起源的子宫癌中，存在胸膜浸润（P  = 0.001）、淋巴结受累（P  = 0.001）和年轻（P  = 0.044 ) 被认为是 OS 的不利预后因素。

结论

技术上可切除的妇科转移瘤的手术治疗可能是一个重要的选择。胸膜浸润和淋巴结转移似乎是不良预后因素。