Efficacy and Prognostic Factors of Surgical Resection for Pulmonary Metastases From Ovarian Cancer

Background/Aim: Pulmonary metastases (PMs) from ovarian cancer are rare, and the efficacy of surgical intervention is unclear. This study aimed to validate the efficacy of surgical intervention for pulmonary metastases from ovarian cancer.

Patients and Methods: Cases were taken from the database of the Metastatic Lung Tumor Study Group of Japan from 1996 to 2021, which prospectively registers surgical cases of pulmonary metastases at participating centers. Only patients who underwent radical surgery for pulmonary metastases from ovarian cancer were included. Factors associated with overall survival (OS) were analyzed.

Results: The analysis included 48 patients with a mean age of 53.2 years old. The 5-year overall survival rate was 69.9% [95% confidence interval (CI)=51.9%-82.2%], with a median survival period of 121 months (95% CI=64-134 months). Predictors of poorer OS included preoperative extrapulmonary metastasis [hazard ratio (HR)=5.354, 95% CI=1.248-22.97; p=0.024], elevated preoperative tumor marker levels (HR=2.999, 95% CI=1.028-8.705; p=0.044), and a disease-free interval of less than 24 months (HR=4.355, 95% CI=1.004-18.89; p=0.049). On multivariable analysis, preoperative extrapulmonary metastasis remained an independent prognostic factor (HR=6.229, 95% CI=1.216-31.92; p=0.028).

Conclusion: This report includes the largest number of patients who underwent resection of PMs from OC. Preoperative extrapulmonary metastasis was identified as an adverse prognostic factor, emphasizing the need for careful consideration of surgical indications. Our results significantly contribute to understanding the prognosis and prognostic factors associated with surgical intervention for PMs from OC.