Clinicopathological and Prognostic Features of 67 Cases With Pulmonary Sarcomatoid Carcinoma: An 18-Year Single Center Experience


Amirov F.

Journal Of Thoracic Oncology, cilt.16, sa.3, ss.376, 2021 (SCI-Expanded)

  • Yayın Türü: Makale / Kısa Makale
  • Cilt numarası: 16 Sayı: 3
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1016/j.jtho.2021.01.607
  • Dergi Adı: Journal Of Thoracic Oncology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.376
  • İstanbul Üniversitesi Adresli: Evet

Özet

Introduction: The incidence of pulmonary sarcomatoid carcinoma
(PSC) is around 0.5% among the subgroups of nonsmall cell lung
cancer (NSCLC). PSC has 5 histological subtypes dened by the
WHO: pleomorc carcinoma, spindle cell carcinoma, giant cell
carcinoma, carcinosarcoma and pulmonary blastoma. In different
series, the age at diagnosis varies between 55-70 years, and it is
more common in males and smokers. These tumorsprognosis is
poorer, even at an early stage. Nevertheless, promising alternative
treatments are on the agenda, with met-amplication and high
levels of PD-L1 seen in of these tumors in recent studies.
Regarding current information, we evaluated the clinicopatholog-
ical and prognostic data of patients in our center. Methods: 67
patients have been identied in the last 18 years.. Gender, age, and
smoking information were recorded. Staging according to 8. edition
of TNM was applied from the pre-treatment images. The correlation
between the information of surgery, chemotherapy and radio-
therapy administered to patients and survival was analyzed.
Immunohistochemical (IHC) staining characteristics and patholog-
ical ndings were taken into account. Overall survival (OS) was
primarily targeted in the survival analysis.Multivariate analysis was
used to analyze the independent factors on OS. Results: The de-
mographic, clinicopathological and survival data are listed in table
1. In accordance with the literature, the disease was more common
in men and smokers but demographic factors didnt affect OS. The
median OS was found to be statistically poorer in the presence of
advanced stage, T4 tumor and lymph node positivity. Median OS
was signicantly higher in patients who had surgery than those who
didnt. Those who received adjuvant-neoadjuvant treatment had the
best survival among the treatment modalities. Tumor subtypes
werent correlated with OS. However, in the subgroup with positive
epithelial marker the median OS signicantly better than negatives.
Surgical treatment and stage 4 disease were determined to be in-
dependent variables in the multivariate analysis (HR: 0,27 and 3,94
respectively).
Conclusion: Because PSC is rare and heterogeneous, it can be
challenging and confusing for the clinician. In our retrospective
data, early multimodal treatments, especially surgery, can
contribute to survival. Because our study is retrospective and
included a small sample size, it has limitations, which makes it
difcult to evaluate our results. New classications for the origin
of the disease will facilitate treatment and follow-up, and new
treatment alternatives will contribute to survival. Larger studies
are needed to achieve these goals. Keywords: sarcomatoid, met
amplication, PD-L1