Distant recurrence from solid tumors shows dismal prognosis. However, recurrence limited to lungs is reported to have relatively long term disease free survival. We assessed the prognostic factors affecting survival outcomes and feasibility of pulmonary metastasectomy in cervical cancer patients who had recurrent disease limited to lungs.
We retrospectively enrolled the patients treated at Samsung Medical Center from 1996 to 2010. Among 2222 patients with cervical cancer, 39 patients who had recurrent cervical cancer limited to lung parenchyma were finally included for the analysis. Age, number of metastatic lesions, metastasectomy, histology, and treatment free interval were included in the Cox model and subsequent recurrence pattern was analyzed.
The median follow-up was 56.7 months (15-121 months) and median overall survival after recurrence was 26.5 months (1-70 months) with 5-year overall survival of 37.1%. The median time interval from the end of previous treatment and diagnosis of the recurrence was 31.3 months (7-67 months). Nineteen of 39 patients (48.7%) had metastasectomy for lung lesions and adjuvant therapy was added in 84.2% (16/19) of these patients. On multivariate analysis, the number of metastatic lesions (1, 2, 3 vs. ≥4; HR, 8.97; 95% CI, 1.174-68.58; p=0.034) were statistically significant prognostic factors for overall survival.
Recurrent cervical cancer limited to the lungs is associated with long term overall survival with multidisplinary treatment approach including surgery and systemic chemotherapy when there are ≤ 3metastases.
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