Przerzuty do pluc u chorych na niezaawansowanego raka endometrium
Author(s): Pawel Blecharz, Marian Reinfuss, Krzysztof UrbaÃ Âski, Tomasz DÃÂ browski, ElÃ Â¼bieta LuczyÃ Âska3, Wiktor Szatkowski
The aim of the study: The presentation of treatment approaches, outcomes and prognostic factors in patient with non-advanced endometrial cancer with lung metastases as the first symptom of treatment failure.
Material and methods: Sixty five percent (52/80) patients were diagnosed with isolated lung metastase and 15% (12/80) with multiple lesions. Moreover, in 20% (16/80) of patients dissemination to lung, liver, bones or brain was diagnosed. Surgical approach with adjuvant hormonotherapy was done in 35 pts with single lesion and palliative radiotherapy for bones or brain metastases was given for 7 pts. The most common therapy was hormono- or chemotherapy, used together with surgery or radiotherapy (42 pts) or alone (38 pts).
Results: Twelve months from diagnosis of dissemination survived 31,3% (25/80) of patients and 36 months – 7,5% (6/80) of patients. Thirty six months survivals were observed only in patients with single lung metastasis, treated with surgery plus hormonotherapy. The response rate for multiagent chemotherapy was 42,9% with 9-month median progression free survival. Prognostic factors for 12-month overall survivals in Cox analysis were time from diagnosis of endometrial cancer to dissemination (with cut-point for 24 months) and number of metastatic lesions (single vs. multiple).
Conclusions: Distant survivals for patients with disseminated non-advanced endometrial cancer can be achieved only in patients with single lung lesion thanks to surgical resection plus hormono- or chemotherapy. Palliative treatment of choice is multiagent chemotherapy with adriamycin, cipslatin and paclitaxel. Prognostic factor in patients with disseminated non-advanced endometrial cancer are time to dissemination and number of metastatic lesions.
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Department of Radiation Oncology
Asahi University Hospital
Gifu city, Gifu, Japan
Maher Abdel Fattah Al-Shayeb
Department of Surgical Sciences, Ajman University, UAE
Institute of Gynecology and Obstetrics, Medical University of Lodz, I Clinic of Gynecology and Gynecological Oncology (Lodz, Poland)
Head of the Oncology Gynecology Clinic, Oncology Center - Instytut im. Maria Sklodowska Curie, Department in Krakow (Krakow, Poland)
Klinika Nowotworow Gornego Odcinka Uklad Digestii, Oncology Center - Institute (Warsaw, Poland)