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 (it 10), VATS (n = 11), and thoracotomies following VATS (it = 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, I segmentectomy, I 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 I 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, 267 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. (C) 2009 Elsevier Inc. All rights reserved.