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Thoracoscopic Surgery to Treat Lung Metastases from Refractory Choriocarcinoma

Authors Zhao L, Qin Y, Ma D, Li L, Han Z, Li S, Liu H

Received 25 February 2020

Accepted for publication 5 May 2020

Published 25 May 2020 Volume 2020:12 Pages 3851—3858

DOI https://doi.org/10.2147/CMAR.S251249

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Antonella D'Anneo


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

Department of Thoracic Surgery, Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730, People’s Republic of China

Correspondence: Hongsheng Liu
Department of Thoracic Surgery, Peking Union Medical College Hospital, Beijing 100730, People’s Republic of China
Tel +86 18519667758
Fax +86 10 69152630
Email pumchlhsnj@163.com

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: video-assisted thoracoscopic surgery, lung metastases, choriocarcinoma

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