Background: Pulmonary sarcomatoid carcinoma (PSC) is a rare malignancy.
Methods: A total of 69 patients with PSC treated at a single institution in southern China with long-term follow-up were evaluated in this study. We analyzed the clinical characteristics, immunohistochemical profiles, epidermal growth factor receptor mutation status, K-RAS mutation status, treatments, and prognosis.
Results: PSC mainly occurred in young male patients with a history of smoking. Most patients received multimodality treatments and the majority had early-stage disease. The median survival time was 19.1 months, and the 5-year survival rate was 17.4%. The patients without distant metastasis, with normal or higher body mass index (≥18.5), with normal hemoglobin, with smaller tumor size (≤4 cm), and those who received complete resection had significantly better overall survival (P<0.05). The patients with pleomorphic carcinoma had much worse prognosis. In a Cox regression model, M stage, pathology, and having received a complete resection were independent prognostic factors (P<0.05).
Conclusions: PSC is a unique lung malignancy with poor prognosis. Patients receiving complete resection had better prognosis, likely a reflection of early-stage disease. Neither neoadjuvant nor adjuvant chemotherapy improved patient survival for those with early-stage disease. The retrospective design and small sample size limited the generalizability. Future multicenter collaborations may be necessary to determine the optimal treatment.
Departments of *Thoracic Surgery
‡Intensive Care Unit
§Pathology, State Key Laboratory of Oncology in South China/Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China
∥Stanford University School of Medicine, Stanford, CA
Presented in part at the 15th World Conference on Lung Cancer (WCLC), abstract 727, October 2013, Sydney, Australia.
Y. Lin, H.Y., and Q.C. contributed equally.
Supported by Department of Health of Guangdong Province (B2009089), Guangdong Province Traditional Chinese Medicine Bureau (20121154), Guangdong Science and Technology Department (2012B031800116), the Science and Technology Planning Project of Guangdong Province (2010B31500010), and the National High Technology Research and Development Program of China (863 Program) (2009AA02Z421).
The authors declare no conflicts of interest.
Ying Liang and Guowei Ma are co-corresponding authors.
Reprints: Ying Liang, MD, PhD, Department of Medical Oncology, State Key Laboratory of Oncology in South China/Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, P.R. China. E-mail: firstname.lastname@example.org; and Guowei Ma, MD, PhD, Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China// Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, P.R. China. Email: email@example.com.