Evaluation of surgical resection of pulmonary metastasis of trophoblastic tumor

Objective: To evaluate the role of the lung lobectomy in gestational trophoblastic tumor patients with lung metastases. Methods: A total of 45 cases of trophoblastic tumor with pulmonary metastases treated by lung lobectomy from 1985~2002 at PUMC hospital were retrospectively analyzed. Seven cases were diagnosed as invasive mole and thirty-eight as choriocarcinoma. Results: Lung lobectomy was performed in all of these patients after several courses of chemotherapy. Seven cases of invasive mole reached complete remission. Eleven cases of choriocarcinoma with stage Ⅲa had received average 13 courses of chemotherapy, 10 of them reached complete remission. Seventeen cases of choriocarcinoma with stage Ⅲb had received average 14.3 courses of chemotherapy, 11 of them reached complete remission. Ten cases of choriocarcinoma with stage Ⅳ had received average 15 courses of chemotherapy, six of them reached complete remission. In the 45 patients, histologic examination disclosed haemorrhagic necrotic tissue in 27 patients, 17 of them reached complete remission(63%). Histologic examination also revealed fibrosis around the focus in 16 patients, 14 of them reached complete remission(88%). Tuberculosis was found in 2 patients.Conclusions: Although the development of effective chemotherapy has resulted in improved survival of patients with gestational trophoblastic tumor, lung lobectomy remains an important adjunct treatment in a selected subset of patients. Pathological examinations can help to estimate the prognosis.

Objective： To evaluate the role of the lung lobectomy in gestational trophoblastic tumor patients with lung metastases. Methods： A total of 45 cases of trophoblastic tumor with pulmonary metastases treated by lung lobectomy from 1985~2002 at PUMC hospital were retrospectively analyzed. Seven cases were diagnosed as invasive mole and thirty-eight as choriocarcinoma. Results： Lung lobectomy was performed in all of these patients after several courses of chemotherapy. Seven cases of invasive mole reached complete remission. Eleven cases of choriocarcinoma with stage Ⅲ a had received average 13 courses of chemotherapy, 10 of them reached complete remission. Seventeen cases of choriocarcinoma with stage Ⅲ b had received average 14.3 courses of chemotherapy, 11 of them reached complete remission. Ten cases of choriocarcinoma with stage Ⅳ had received average 15 courses of chemotherapy, six of them reached complete remission. In the 45 patients, histologic examination disclosed haemorrhagic necrotic tissue in 27 patients, 17 of them reached complete remission（63%）. Histologic examination also revealed fibrosis around the focus in 16 patients, 14 of them reached complete remission（88%）. Tuberculosis was found in 2 patients. Conelusions： Although the development of effective chemotherapy has resulted in improved survival of patients with gestational trophoblastic tumor, lung lobectomy remains an important adjunct treatment in a selected subset of patients. Pathological examinations can help to estimate the prognosis.