Sarcomatoid carcinoma of the lung is characterized by worse prognosis, and generally felt to be chemo-refractory compared with other non-small cell lung cancer. We conduct this retrospective study to investigate the clinical characteristics of patients with sarcomatoid carcinoma of the lung and determine the optimal treatment strategies.
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.
Kaplan-Meier and Cox regression analyses showed pathological stage (8th edition) is the independent prognostic factor (P = 0.001, HR = 2.601, 95%CI(1.447-4.675)) for pulmonary sarcomatoid carcinoma. 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)).
Pathological stage (8th edition) is independent prognostic factor for sarcomatoid carcinoma of the lung. Surgery followed by adjuvant chemotherapy should be considered for stage I pulmonary sarcomatoid carcinoma. Further prospective studies are needed to confirm these results.
Clinical trial identification
Legal entity responsible for the study
The Fourth Hospital of Hebei Medical University.
Has not received any funding.
The author has declared no conflicts of interest.