Pathologic diagnosis and resection of suspicious thoracic metastases in patients with cervical cancer through thoracotomy or video-assisted thoracic surgery.

OBJECTIVES

The purpose of this study was to clarify the role of resection for suspicious thoracic metastasis in cervical cancer patients with thoracotomy or video-assisted thoracic surgery (VATS).

METHODS

A retrospective study was performed involving patients with primary and recurrent cervical cancer who underwent surgical resections for suspicious thoracic metastatic lesions at a single academic institution between January 2003 and February 2009.

RESULTS

Twenty-three pulmonary resections were performed on 21 patients via thoracotomies (n=10), VATS (n=11), and thoracotomies following VATS (n=2). All suspicious pulmonary lesions were completely resected in all 3 surgical groups. A total of 49 surgical procedures were performed, as follows: 25 wedge resections, 9 lobectomies, 12 mediastinal lymph node dissections, 1 segmentectomy, 1 diaphragmatic resection, and 1 pleurectomy. The pathologic evaluation revealed metastasis from cervical cancer, primary lung cancer, no pathologic abnormality, and tuberculosis in 14, 7, 2, and 1 of the surgical specimens, respectively; 1 patient had primary lung cancer and mediastinal lymph node metastasis from cervical cancer. Different pathologic diagnoses were rendered in 6 patients compared to the image-based diagnoses. After pulmonary metastasectomy, 2 patients died from the disease, 3 patients were alive with disease, and 16 patients were alive without disease, with a median follow-up of 16 months (range, 2-67 months).

CONCLUSIONS

Resection of suspicious thoracic metastasis with thoracotomy or VATS permits accurate pathologic diagnosis and favorable curative resection in selected patients with cervical cancer.