Pulmonary sarcomatoid carcinoma: progress, treatment and expectations

Li, Xin; Wu, Di; Liu, Hongyu; Chen, Jun

doi:10.1177/1758835920950207

Cited by 52 publications

(79 citation statements)

References 89 publications

(343 reference statements)

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“…She was given chemotherapy with carboplatin and nab-paclitaxel. Studies have shown that EGFR mutations can be found in 8.8% (Li et al, 2020) and ALK rearrangement in 3.5% of SC of lung patients (Chen et al, 2017). Our patient reported negative for both.…”

Section: Discussionsupporting

confidence: 45%

Case Report: Pulmonary sarcomatoid carcinoma in a female patient from Nepal

et al. 2021

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Sarcomatoid carcinoma of the lung is an uncommon subtype of non-small-cell lung cancer (NSCLC). Even in the early stages, pulmonary sarcomatoid carcinoma (PSC) has a dismal prognosis when compared to other kinds of NSCLC with a mean survival of 9–12 months and a five-year survival rate of around 20%. We present the case of a 68-year-old woman with a two-month history of shortness of breath and cough. Initial computed tomography (CT) scan showed features of interstitial lung disease with chronic obstructive airway changes. After 34 months, the patient’s condition worsened with newer complaints of sore throat and hemoptysis. A repeat CT scan showed a ∼49x38x59mm size lesion in the superior segment of the left lower lobe. A core needle biopsy was performed, which revealed tumor cells consisting of irregular tubules and sarcomatoid components. The patient was started on chemotherapy. Unfortunately, she succumbed to her disease. Our case highlights the aggressiveness of PSC.

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Section: Discussionsupporting

confidence: 45%

Case Report: Pulmonary sarcomatoid carcinoma in a female patient from Nepal

et al. 2021

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“…The result shows no difference in SaPC with these treatments-the first two patients received postoperative chemotherapy but relapsed in months. In terms of sarcomatoid carcinoma in other organs such as kidney (66) and lung (67), they show the similar clinicopathological characteristics as SaPC, and targeted therapy has been confirmed to be potentially beneficial. This may be the future direction of treatment for SaPC.…”

Section: Discussionmentioning

confidence: 92%

Case Report and Systematic Review: Sarcomatoid Parathyroid Carcinoma—A Rare, Highly Malignant Subtype

Wang

et al. 2021

Front. Endocrinol.

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BackgroundParathyroid carcinoma (PC) is a rare malignancy, the incidence of which is less than 1/1 million per year. Sarcomatoid parathyroid carcinoma (SaPC) is an extremely peculiar subtype; only three cases have been reported internationally. It consists of both malignant epithelial components and sarcomatoid components (mesenchymal origin) simultaneously. This “confusing” cancer exhibits higher invasiveness, and traditional surgery does not appear to achieve the expectation, which differs significantly from that of general PC.ObjectiveTo characterize the clinicopathologic features of SaPC and explore similarities and differences between SaPC and general PC.Materials and MethodsWe collected clinical data of SaPC cases from our center and literature. The SaPC case in our center was presented. To better understand the characteristics of SaPC, we also reviewed clinical information in general PC cases from our center and literature within the last 5 years, and a systematic review was performed for further comparison.ResultsA 60-year-old woman was admitted for a neck mass and hoarseness. After the surgery, she was confirmed as SaPC and ultimately developed local recurrence at 3 months. Together with the reported cases from literature, four cases of SaPC (three cases from literature) and 203 cases of general PC (200 cases from literature) were reviewed. Both tumors showed obvious abnormalities in parathormone (PTH) level and gland size. Compared to general PC, SaPC has a later age of onset (60.50 ± 7.42 vs. 51.50 ± 8.29), relatively low levels of PTH (110.28 ± 59.32 vs. 1,156.07 ± 858.18), and a larger tumor size (6.00 ± 1.63 vs. 3.14 ± 0.70). For SaPC, all four cases were initially misdiagnosed as thyroid tumors (4/4). Spindle cell areas or transitional zones were common pathological features in SaPC cases (3/4).ConclusionSaPC is a very rare pathologic subtype of PC and appears to be much more easily misdiagnosed as a thyroid tumor. Spindle cell areas or transitional zones are highly possible to be pathological features in its sarcomatoid components. Despite many similarities, there are some differences between SaPC and general PC—SaPC does not show the obvious endocrine feature but stronger aggressiveness. Surgical treatment of SaPC does relieve life-threatening symptoms and improve quality of life even with recurrence in the short term.

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“… 6 , 26 The median survival and 5-year OS in the present study were lower than those in other real-world studies. 30 , 31 This was probably because patients with PSC in the SEER database had more aggressive grades and stages at diagnosis and had less opportunity to receive surgery (28.2%), which was absolutely associated with a poor prognosis. PSC was classified into 5 subgroups with different prognoses.…”

Section: Discussionmentioning

confidence: 99%

Establishment of a Competing Risk Nomogram in Patients with Pulmonary Sarcomatoid Carcinoma

Liang

Zhang

Duan

et al. 2022

Technol Cancer Res Treat

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Background and aim: Pulmonary sarcomatoid carcinoma (PSC) is a rare subtype of nonsmall cell lung cancer with a poor prognosis. This study aimed to analyze the clinicopathological characteristics and survival outcomes among patients with PSC, lung squamous cell cancer (SCC), and lung adenocarcinoma (LAC), and to construct a competing risk nomogram for patients with PSC. Method: Data of 3 groups of patients diagnosed with PSC, SCC, or LAC from the surveillance, epidemiology, and end results (SEER) database between 1988 and 2015 were retrospectively reviewed. A 1:1 propensity score matching (PSM) analysis was used to balance the baseline data of patients. Independent risk factors associated with survival outcomes were screened by the least absolute shrinkage and selection operator and further determined by univariate and multivariate Cox proportional risk regression analyses. The overall survival (OS) of patients was evaluated by Kaplan–Meier analysis and compared with a log-rank test. The cumulative incidence function was used to estimate the 5-year probabilities of the cancer-specific mortality of PSC. A nomogram was constructed to illustrate the competing risk model to predict the 3- and 5-year OS, and corresponding concordance indexes (C-indexes) and calibration curves were used to assess and validate the competing risk nomogram. Results: A total of 2285 patients with PSC were included in this study. Compared with SCC and LAC patients, the Kaplan–Meier analysis showed that patients with PSC had a worse prognosis, with a median survival of 5 months (95% confidence interval [CI]: 5-6 months) and a 5-year OS rate of 15.3% (95% CI: 13.9%-16.9%). Similar outcomes were demonstrated after 1:1 PSM. Moreover, the competing risk model showed that age, T stage, M stage, tumor size, lymph node ratio (LNR), surgery, and chemotherapy were associated with PSC-specific mortality. The 5-year C-index of the nomogram was 0.718. Calibration curves illustrated that the nomogram was well-validated and had great accuracy. Conclusions: Patients with PSC had a worse survival outcome compared with SCC or LAC patients. Age, T stage, M stage, tumor size, LNR, surgery, and chemotherapy were associated with PSC-specific mortality. The competing risk nomogram displayed excellent discrimination in predicting PSC-specific mortality.

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Pulmonary sarcomatoid carcinoma: progress, treatment and expectations

Cited by 52 publications

References 89 publications

Case Report: Pulmonary sarcomatoid carcinoma in a female patient from Nepal

Case Report: Pulmonary sarcomatoid carcinoma in a female patient from Nepal

Case Report and Systematic Review: Sarcomatoid Parathyroid Carcinoma—A Rare, Highly Malignant Subtype

Establishment of a Competing Risk Nomogram in Patients with Pulmonary Sarcomatoid Carcinoma

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