Role of surgical resection for lung, liver, and central nervous system metastases in patients with gynecological cancer: a literature review

Abstract

Many reports of ovarian, cervical, and uterine cancers metastatic to lung, liver, and brain have been published. A fewer number of them focused on the surgical treatment for these patients. We reviewed the published literature, regarding surgical management of metastatic disease in patients with gynecological cancer. Some prognostic factors in the patients with metastatic lesions from these three different cancers were found in common. Favorable prognostic factors for a prolonged survival were good performance status of the patients, long disease-free interval, absence of other systemic disease, and the resectability, preferably with a clear margin. These factors should be considered as the criteria for surgery. In well-selected patients, survival could be extended from the surgical procedure with minimal complications. Other types of treatment such as radiation therapy or chemotherapy could also be given in conjunction with surgery, depending on tumor type and disease status of the primary cancer, other systemic diseases, and residual metastatic lesions after surgery.

Surgery of Liver Metastasis in Gynecological Cancer – Indication and Results

“…Because our data represent a selection of patients undergoing liver surgery and there is no randomized control group, this uncertainty could lead to the hypothesis that the role of hepatic surgery for this group is cytoreduction only in chemotherapy-responsive tumors. As we know from the literature [13], in ovarian cancer, surgical cytoreduction of intraperitoneal disease has a substantial effect on survival, whether performed as a primary treatment, interval debulking, or secondary debulking for recurrent cancer. In this type of gynecological cancer, survival of patients with partial hepatectomy is similar to that of patients without liver disease but with similar volumes of residual cancer [20][21].…”

“…Interestingly, a recent multicenter study by Adam et al [12] showed that liver resection for non-colorectal, nonendocrine metastases is becoming more prevalent. In gynecological malignancies, metastasis to the liver is an indicator of advanced cancer disease [13]. In the literature, the efficacy of liver surgery for patients with liver metastases from gynecological cancers has remained unclear.…”

Squamous Cell Carcinoma of Vaginal Vault with Liver, Adrenal and Brain Metastases: Report of an Uncommon Presentation

“…Primary SqCC of cervix most commonly disseminate to the lung (21%), bone (16%), para-aortic lymph-nodes (11%), abdomen (8%) followed by supra-clavicular lymph-nodes (7%) [1], while liver metastases are relatively rare being reported in 1.2% to 4% of cases only [1][2][3]. Metastatic involvement of adrenals by primary SqCC cervix is rare [4] and those reported are mainly from adenocarcinoma of cervix [16].…”

“…The most common locations for distant metastases from SqCC of cervix are the lung (21%), bone (16%), para-aortic lymph-nodes (11%), abdomen (8%) followed by supraclavicular lymph-nodes (7%) [1] while liver metastases are relatively rare, being reported in 1.2% to 4% of cases only [1][2][3]. Adrenal metastases from primary SqCC cervix are rarely reported in literature [4] while brain metastases are extremely rare [1,5,6] with an incidence of 0.4%-1.2% [7][8][9][10].…”

Effect of Quercetin on RAC1 Gene Expression as a Marker of Metastasis in Cervical Cancer Cells

“…Although cervical cancer mortality rates have been decreasing, the recurrence and metastasis of cervical cancer to other parts such as the lymph nodes [2,3], lungs [4,5], bones [6,7], liver [8] and bowels [9] are main factors contributing to mortality in patients with cervical carcinoma. Thus, apart from surgery and the destruction of cervical cancer cells by medications, inhibiting metastasis is an auxiliary strategy for treating patients with cancers.…”