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. 2020 May 25:12:3851-3858.
doi: 10.2147/CMAR.S251249. eCollection 2020.

Thoracoscopic Surgery to Treat Lung Metastases from Refractory Choriocarcinoma

Luo Zhao  1 , Yingzhi Qin  1 , Dongjie Ma  1 , Li Li  1 , Zhijun Han  1 , Shanqing Li  1 , Hongsheng Liu  1
Affiliations

Thoracoscopic Surgery to Treat Lung Metastases from Refractory Choriocarcinoma

Luo Zhao et al. Cancer Manag Res. .

Abstract

Purpose: To assess the use of video-assisted thoracoscopic surgery to treat lung metastases from refractory choriocarcinoma.

Patients and methods: We reviewed patients diagnosed with refractory choriocarcinoma who underwent lung resection by video-assisted thoracoscopic surgery combined with chemotherapy between October 2013 and August 2019 at the Peking Union Medical College Hospital. The surgical records, pathologic findings and survival rates were analyzed.

Results: The study included 73 patients who underwent 78 thoracoscopic surgeries. Most patients underwent lobectomy (48.7%), and 17 patients (21.8%) underwent resection of more than one lobe. The median operation time and bleeding volume were 95 minutes and 50 mL, respectively. The median duration of chest tube use and hospital stay were 3 days and 4 days, respectively. Postoperative complications were documented in 6 patients (7.7%). The thoracic lymph nodes were harvested in 51 patients (65.4%), but none of these patients had positive nodes. A total of 69.2% of the patients had positive pathologic findings. The mean follow-up time was 30 months. During follow-up, 11 patients experienced disease relapse, and 2 of them died because of brain metastasis. The overall disease-free rate was 83.6%, and the survival rate was 97.0% after excluding those lost to follow-up. Patients with decreased postoperative β-hCG showed a higher disease-free rate during follow up (P<0.05).

Conclusion: The minimally invasive video-assisted thoracoscopic approach is a valuable and safe treatment for refractory choriocarcinoma patients with lung metastases. Lymphadenectomy is not suggested for these patients. Patients with decreased postoperative β-hCG levels may achieve a much better prognostic result.

Keywords: choriocarcinoma; lung metastases; video-assisted thoracoscopic surgery.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The disease-free analysis of patients (N=67). (A) The overall disease-free rate was 83.6%. (B) Patients with decreased postoperative β-hCG showed a higher disease-free rate.
Figure 2
Figure 2
Subgroup disease-free analysis were showed by preoperative β-hCG level (A), lesion numbers (B), lesion size (C) and FIGO stage (D).
Figure 3
Figure 3
Typical lung metastases from choriocarcinoma. (A) Solid and yellow with necrosis in the middle of the nodule (yellow arrow). (B) CT image (red arrow).
See this image and copyright information in PMC

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