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American Journal of Clinical Oncology:
doi: 10.1097/COC.0000000000000101
Original Articles: Thoracic

Characteristics and Prognostic Analysis of 69 Patients With Pulmonary Sarcomatoid Carcinoma

Lin, Yongbin MD, PhD; Yang, Han MD, PhD; Cai, Qingqing MD, PhD; Wang, Daofeng MD, PhD; Rao, Huilan MD, PhD; Lin, Suxia MD, PhD; Long, Hao MD, PhD; Fu, Jianhua MD, PhD; Zhang, Lanjun MD, PhD; Lin, Peng MD, PhD; Xu, Guangchuan MD; Rong, Tiehua MD; Xiong, Xiaoxing MD, PhD; Ma, Guowei MD, PhD; Liang, Ying MD, PhD

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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.

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.


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