Pulmonary Metastasectomy for Uterine Cancer: Diagnostic Role and Long-term Outcomes in a Retrospective Study

Pulmonary metastases from uterine cancer are rare, and clinical significance of pulmonary metastasectomy (PM) in such cases remains unclear due to limited data. We retrospectively reviewed 10 female patients who underwent PM for metastatic uterine cancer between 2010 and 2023. Clinical and pathological data, including disease-free interval (DFI), number and size of metastatic lesions, and overall survival (OS), were analyzed. Univariate analysis was performed to identify the prognostic factors. The median age of patients at the time of PM was 63 years. The primary tumor originated from the uterine body in seven cases and from the cervix in three cases. Histological subtypes included endometrioid adenocarcinoma (n = 6), squamous cell carcinoma (n = 3), and serous carcinoma (n = 1). Eight patients had a single metastasis and two had multiple lesions. The median DFI was 16 months and the median OS following PM was 96 months. Univariate analysis revealed that a single metastasis (p = 0.0182) and DFI ≥ 10 months (p = 0.0215) were significantly associated with better OS. Tumor size ≥ 12 mm showed a trend toward improved survival (p = 0.0529). PM was beneficial for histological confirmation in patients with uncertain preoperative diagnosis. In all 10 cases, imaging could not distinguish pulmonary metastasis from primary lung carcinoma. Thus, histopathological examination after PM was essential for final diagnosis. PM may provide diagnostic value and potential survival benefits in selected patients with uterine cancer, particularly in those with limited metastases and a longer DFI.