期刊
AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS
卷 39, 期 3, 页码 215-222出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/COC.0000000000000101
关键词
pulmonary sarcomatoid carcinoma; lung cancer; EGFR mutation; OS
类别
资金
- Department of Health of Guangdong Province [B2009089]
- Guangdong Province Traditional Chinese Medicine Bureau [20121154]
- Guangdong Science and Technology Department [2012B031800116]
- Science and Technology Planning Project of Guangdong Province [2010B31500010]
- National High Technology Research and Development Program of China (863 Program) [2009AA02Z421]
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.
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