Clinicopathological features and prognostic analysis of metastatic pulmonary sarcomatoid carcinoma: a SEER analysis

Abstract

Background: Pulmonary sarcomatoid carcinoma (PSC) is a rare type of non-small cell lung cancer (NSCLC). Metastases are often detected at the first diagnosis. Despite high rates of distant metastasis, there is insufficient data describing the characteristics of PSC metastasis.Methods: We performed a Surveillance, Epidemiology, and End Results (SEER) database-based analysis of clinicopathological features and prognosis of distant metastasis in PSC patients. Data queried for this analysis included PSC patients in the database between 2010 and 2016. Results: A total of 934 patients met the criteria for inclusion in the analysis and included, at the time of diagnosis, 512 (54.8%) patients with metastasis, including bone (n=152; 16.3%), brain (n=108; 11.6%), liver (n=70; 7.5%), lung (n=142; 15.2%) metastases. Binary logistic regression showed that patients with giant cell carcinoma [odds ratio (OR) 4.023, 95% confidence interval (CI): 2.113-7.661, P<0.001] and spindle cell carcinoma (OR 3.151, 95% CI: 1.699-5.843, P<0.001) were associated with metastasis. Log-rank test and Kaplan-Meier plots indicated poor prognosis in metastatic patients [the 1-, 3-, and 5-year overall survival (OS) rates were 14.1%, 5.5%, and 4.8%, respectively]. Multivariable analysis showed younger and chemotherapy as improved prognostic factors of PSC patients with single metastasis site. Conclusions: The SEER database-based analysis revealed the clinical features of distant metastasis of PSC and showed that different histological types posed distinct metastasis potential. Besides, age and chemotherapy were the independent prognostic factors of PSC patients with single metastasis site.

Characteristics and Prognostic Analysis of 55 Patients With Pulmonary Sarcomatoid Carcinoma

“…A large-scale retrospective analysis of pulmonary sarcomatoid carcinoma conducted by Xiao et al., via the SEER database, found that the proportion of pulmonary sarcomatoid carcinoma was only 0.5% of lung cancer worldwide ( 10 ).In this current study, the 55 patients with pulmonary sarcomatoid carcinoma accounted for only 0.16% of the patients diagnosed with lung cancer during the same period, which was slightly lower than that reported by Li et al. ( 11 – 14 ).…”

Persistent fecal occult blood due to the small intestinal metastasis of pleomorphic lung carcinoma

“…Pleomorphic carcinoma of the lung is a relatively rare pathologic diagnosis that accounts for approximately 0.1–0.4% of non-small cell lung cancer [ 5 ]. The prognosis of pleomorphic carcinoma has been reported to be worse than adenocarcinoma or squamous cell carcinoma [ 6 ] because of the aggressive tumor progression, including distant organ metastasis [ 7 ]. Any type of non-small cell lung carcinoma can metastasize to distant organs, including the GI tract; however, a study has shown that pleomorphic carcinomas are significantly associated with GI tract metastasis than other types of non-small cell lung carcinomas [ 8 ].…”

Successful control of intestinal bleeding from metastasis of pulmonary pleomorphic carcinoma with pembrolizumab: A case report

“…[3] It has a more aggressive clinical course and a poorer response to chemotherapy than other forms of lung malignant tumors. [4,5] Our case showed intestinal bleeding due to small intestinal metastasis of pulmonary pleomorphic carcinoma, although intestinal bleeding is not a very common initial sign of recurrence of resected lung malignant tumors. It was reported that 11.9% of lung cancer patients had gastrointestinal metastases according to an autopsy analysis.…”

“…[ 3 ] It has a more aggressive clinical course and a poorer response to chemotherapy than other forms of lung malignant tumors. [ 4 , 5 ]…”