Prognostic factors for sarcomatoid carcinomas of lung: A single-centre experience

Abstract

Background: Although lung sarcomatoid carcinomas (LSCa) arised from the epithelial tissue, they have very distinctive features than other non-small cell lung carcinomas in terms of histopathology and survival. It constitutes 0.1%–0.4% of all lung cancers. The aim of our study is to evaluate the survival analysis of LSCa in a single thoracic surgery clinic and to determine the prognostic factors. Materials and Methods: It was a retrospective cohort study. After the approval of the local ethics committee, a total of 34 patients who were operated in our department between January 2010 and December 2018, whose pathologies were reported as sarcomatoid carcinoma was included in the study. The patients were analyzed by age, gender, presence of necrosis in the histopathological examination, tumor stage, tumor diameter, and tumor location. Results: There were 28 males and 6 females. The median age was 60 years (range: 36–80 years). The median survival was 42 months (32.6–52.2 months), and the 5-year overall survival was 33.6%. Significantly negative prognostic factors were tumor diameter and tumor stage ( P = 0.003 and 0.001, respectively). Median disease-free interval (DFI) was 38 months (27.3–49.1 months), and 5-year DFI was 32.6%. Conclusion: LSCa are highly heterogeneous epithelial malignancies, and it has worse survival than other epithelial cancers. Relatively, satisfactory results can be obtained in these tumors with surgical treatment.

Extended radical resection and chest wall reconstruction for a pulmonary sarcomatoid carcinoma: a case report

“…Therefore, we performed a right upper lobectomy, systematic lymph node dissection, and extended resection of the chest wall and part of the ribs with a margin distance of > 2 cm to achieve R0 resection in this patient. This treatment choice possibly minimized the likelihood of tumor recurrence and improved long-term survival [ 4 ]. The final pathologic findings also supported the rationality of extended resection.…”

“…It is insensitive to conventional chemoradiotherapy, making surgery an important treatment modality [ 3 ]. Even in patients with PSC invading the chest wall, complete resection of the primary tumor and the affected chest wall is reportedly beneficial for long-term survival without evidence of lymph node metastasis [ 4 ]. However, chest wall resection destroys the stability and airtightness of the thoracic cavity, and resection of a large area of the bony chest wall may even cause chest wall softening, paradoxical breathing, and scoliosis [ 5 , 6 ].…”

Sarcomatoid lung cancer in a 56-year-old woman

“…Sarcomatoid lung carcinoma (SLC) is a poorly differentiated non-small cell lung cancer (NSCLC), representing up to 0.4% of pulmonary malignancies and 0.52% of the NSCLCs, and a biphasic histopathologic feature showing carcinomatous and sarcomatous data. [1][2][3][4][5][6][7][8] Over 50% of the SLCs have the pleomorphic pattern, followed by spindle cell, giant-cell, carcinosarcoma, and blastoma subtypes. [1][2][3] SLC more frequently affects elderly males, tobacco smokers, and can develop both as an endobronchial exophytic growth or a rounded voluminous mass that may involve the thoracic wall similarly to the mesotheliomas.…”

“…[1][2][3][4][5][6][7][8] Over 50% of the SLCs have the pleomorphic pattern, followed by spindle cell, giant-cell, carcinosarcoma, and blastoma subtypes. [1][2][3] SLC more frequently affects elderly males, tobacco smokers, and can develop both as an endobronchial exophytic growth or a rounded voluminous mass that may involve the thoracic wall similarly to the mesotheliomas. [1][2][3][4]6 SLC and sarcomatoid mesothelioma may have similarities causing diagnostic challenges, and the distinction between them is more relevant due to the option for targeted therapy.…”

Anlotinib Combined With Chemotherapy for Recurrence of Pulmonary Sarcomatoid Cancer Previously Surgically Treated: A Case Report and Literature Review

“…Sarcomatoid carcinoma (SC) is a rare malignancy with a combination of epithelial and sarcoma or sarcoma-like components ( 1 , 2 ). Pulmonary sarcomatoid carcinomas (PSCs) are a heterogeneous group of non-small-cell lung carcinomas containing five subgroups, namely pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, carcinosarcoma, and pulmonary blastoma, which comprise 0.1% to 0.4% of all pulmonary malignancies ( 3 ).…”