Adjuvant Chemotherapy After Lung Metastasectomy in Recurrent Uterine Cervical Cancer with Oligometastasis

Oligometastases of uterine cervical cancer, particularly in the lungs, present a challenging clinical scenario, as clear guidelines for adjuvant therapy following metastasectomy are lacking. This study investigated whether postoperative chemotherapy is necessary for patients with completely resected pulmonary oligometastases. This multicenter retrospective study included 40 patients with recurrent cervical cancer and pulmonary oligometastasis who underwent complete metastasectomy between April 2005 and December 2018. Patients were divided into a chemotherapy group (n = 14) and a chemotherapy-free group (n = 26). We compared the 5-year overall survival and progression-free survival from metastasectomy and evaluated the prognostic factors using univariate and multivariate analyses. The 5-year progression-free survival rates were 64.3% (95% CI, 34.3–83.3%) and 53.0% (95% CI, 32.2–70.1%) in the chemotherapy and chemotherapy-free groups, while the 5-year overall survival rates were 77.9% (95% CI, 45.9–92.3%) and 84.9% (95% CI, 64.0–93.9%), respectively. A total of eight deaths occurred during follow-up, including three in the chemotherapy group and five in the chemotherapy-free group. No statistically significant differences in progression-free or overall survival were observed between the two groups. However, the small sample size, limited number of survival events, and potential selection bias preclude definitive conclusions regarding the benefit of postoperative chemotherapy. Further large-scale, multicenter studies are warranted to clarify its role following complete resection of pulmonary oligometastases from cervical cancer.