by Mohd Sufyan, BSME, MBA Last updated on September 27, 2019,
Can endometrial cancer or uterine cancer spread to lungs?
The lung is a common site for endometrial cancer metastasis. According to a study published in the Journal of Chinese medicine, pulmonary failure was reported to be observed in 1.9–9% of patients with first recurrence of the endometrial cancer.
Endometrial cancer metastasis to lungs
There is limited data to predict pulmonary recurrence in case of endometrial cancer spread to lungs. However, it was reported that pulmonary recurrence was associated with Stage IV disease and deep myometrial invasion. Some earlier reports had even stated that pulmonary recurrence was associated with poor prognosis and that 75% of the total patients with pulmonary recurrence expired from the metastatic endometrial cancer in the 1st year.
Endometrial cancer recurrence in lungs
The longest interval until lung metastasis from endometrial carcinoma was 110 months.
According to a report published in the Japanese Journal of Clinical Oncology, lung metastasis from endometrial carcinoma was detected 17 years after the initial treatment of cancer, which was thought to be the longest interval to lung metastasis reported by then. About 80% of all recurrences of endometrial carcinoma to lungs occur within 3 years after the onset of the treatment and the median interval from initial treatment to detection of lung metastases from endometrial cancer is 12 months.
Lung metastases from uterine cancer are characterized by smooth borders with no cavitation, but these findings are non-specific for endometrial cancer.
Endometrial cancer metastasis to lung symptoms
Endometrial cancer metastasis to lungs can cause severe lung complications. Development of pulmonary symptoms can indicate the spread to lungs, though by this time your doctor might already knew about the spread from the diagnostic tests. Doctors do not usually ignore the possibility of lung cancer metastasis in patients who have adenocarcinoma on biopsy of a uterine mass.
As found in a study, some patients had symptoms such as dyspnea, gastrointestinal issues, abdominal distension, coughing, bleeding, and severe fatigue.
Endometrial cancer metastasis to lung prognosis and survival rate
The prognostic factors, as discussed in a research paper published in the Journal of Gynecologic Oncology, which can predict good survival in primary endometrial malignancy that metastasizes to lung are:
- disease-free interval > 12 months
- grade 1-2 histology
- oestrogen-receptor positivity
- < 50% myometrial invasion
- unilateral lung lesions
- lesion < 2 cm in size
- < 5 nodular lesions in one lung
In most cases, the treatment followed for such metastatic cancer is surgery, followed by chemotherapy. Nonsurgical treatments such as radio-frequency ablation, regional chemotherapy, systemic chemotherapy, cryotherapy, stereotactic radiosurgery, and stereotactic body radiotherapy are also considered. Only surgery is not a suitable option for stage 4 metastatic cancers.
Intrabronchial artery infusion chemotherapy with systemic chemotherapy and radiotherapy are also being evaluated in researches, with > 2-year survival. Hormonal treatment has also been traditionally used.
If diagnosed after a long, disease-free interval, pulmonary metastasis from endometrial carcinoma can have a fairly good prognosis. However, it is important to review the lung lesion against the background of an earlier malignancy of the endometrium. Proper treatment such as involving multi-modalities with surgery, combined options of chemoradiation and followup maintenance with hormonal treatment, can provide a better outcome and an improved survival rate. Prompt evaluation of the findings can help to improve the survival.
