Clinical outcomes and treatment strategies of sarcomatoid carcinoma of the lung

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Thoracic Malignancies
Sarcoma
Therapy
Presenter Yan Wang
Citation Annals of Oncology (2018) 29 (suppl_9): ix139-ix142. 10.1093/annonc/mdy445
Authors Y. Wang
  • Thoracic Surgery, 4th Hospital Hebei Medical University, 50011 - Shijiazhuang/CN

Abstract

Background

Sarcomatoid carcinoma of the lung is characterized by worse prognosis, and is generally felt to be chemo-refractory compared with other non-small cell lung cancer. We conducted this retrospective study to investigate the clinical characteristics of patients with sarcomatoid carcinoma of the lung and determine the optimal treatment strategies.

Methods

We reviewed the medical records of 8176 patients with resected lung cancer in a single high-volume institution between 2008 and 2015. All patients with pathologically diagnosed sarcomatoid carcinoma were evaluated. Clinicopathologic data were analyzed using Kaplan-Meier analysis and Cox regression analysis. Subgroups stratified by pathological stage were analysed to determine the optimal treatment modality. We also conducted subgroup analysis of overall survival among pulmonary sarcomatoid carcinoma and other NSCLC patients.

Results

Kaplan-Meier and Cox regression analyses showed pathological stage (AJCC 8th edition) is the independent prognostic factor [P = 0.001, HR = 2.601, 95%CI (1.447-4.675)] for pulmonary sarcomatoid carcinoma (PSC). Overall survival favored other NSCLC over PSC across subgroups. Male [HR = 0.695, 95%CI (0.505-0.955)], age above 60 years [HR = 0.622, 95%CI (0.417-0.928)], never-smoker [HR = 0.583, 95%CI (0.383-0.888)], patients who had no alcohol abuse history [HR = 0.597, 95%CI (0.416-0.856)], tumor size >5cm [HR = 0.700, 95%CI (0.492-0.995)], tumor stage T1 [HR = 0.383, 95%CI (0.167-0.877)], tumor location in peripheral [HR = 0.577, 95%CI (0.367-0.906)], or in both peripheral and central [HR = 0.626, 95%CI (0.424-0.923), node stage N0 [HR = 0.599, 95%CI (0.403-0.891)], stage Ia [HR = 0.362, 95%CI (0.131-1.000)], stage Ib [HR = 0.450, 95%CI (0.278-0.729)], surgery alone [HR = 0.712, 95%CI (0.507-0.999)].

Conclusions

Pathological stage (AJCC 8th edition) is an independent prognostic factor for sarcomatoid carcinoma of the lung. Surgery followed by adjuvant chemotherapy should be considered for stage I PSC. Further prospective studies are needed to confirm these results.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

The 4th Hospital of Hebei Medical University.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.