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Published in: World Journal of Surgical Oncology 1/2013

Open Access 01-12-2013 | Research

Pulmonary sarcomatoid carcinoma: a clinicopathologic study and prognostic analysis of 51 cases

Authors: Si-Yuan Huang, Shu-Jing Shen, Xing-Ya Li

Published in: World Journal of Surgical Oncology | Issue 1/2013

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Abstract

Background

Pulmonary sarcomatoid carcinoma is a diagnostically challenging group of tumors. It’s a rare histologic subtype of non-small cell lung cancer.There are five subgroups of pulmonary sarcomatoid carcinoma, they are identified as pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, carcinosarcoma, and pulmonary blastoma. We explored the clinicopathologic features and prognostic factors of this tumor.

Methods

We analyzed retrospectively the clinicopathological data of 51 patients with pulmonary sarcomatoid carcinoma who were treated in the First Affiliated Hospital of Zhengzhou University, Henan Cancer Hospital and Henan People Hospital from January 2005 to December 2012. The correlation between prognosis and age, sex, smoking history, tumor size, TNM staging, and treatment modality was analyzed by the statistical software SPSS 17.0. The survival analysis was conducted using the Kaplan-Meier method. The factors influencing survival were analyzed using univariate (Log-rank) and multivariate (Cox) models.

Results

The overall survival rates at 1, 2, 3 and 5 years were 45.5%, 35.8%, 28.2% and 20.1%, respectively. Cox univariate analyses revealed that age, tumor size, T stage, M stage, surgery or not, and postoperative chemotherapy or not, were prognostic factors. Cox multivariate analysis found that tumor size and M stage were independent prognostic factors for PSC.

Conclusions

Due to its rarity and the lack of large-scale clinical trial evidence, few studies about PSC have been reported, its clinical and pathological characteristics remain unclear, and its preoperative diagnosis and investigation of novel treatment approaches are imperative. In our study, the main factors affecting the prognosis of tumor size and M staging are the crucial prognostic factors for PSC. Surgical resection and postoperative adjuvant chemotherapy might result in better prognosis.
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Literature
1.
go back to reference Park JS, Lee Y, Han J, Kim HK, Choi YS, Kim J, Shim YM, Kim K: Clinicopathologic outcomes of curative resection for sarcomatoid carcinoma of the Lung. Oncology. 2011, 81: 206-213. 10.1159/000333095.CrossRefPubMed Park JS, Lee Y, Han J, Kim HK, Choi YS, Kim J, Shim YM, Kim K: Clinicopathologic outcomes of curative resection for sarcomatoid carcinoma of the Lung. Oncology. 2011, 81: 206-213. 10.1159/000333095.CrossRefPubMed
2.
go back to reference Pelosi G, Sonzogni A, De Pas T, Galetta D, Veronesi G, Spaggiari L, Manzotti M, Fumagalli C, Bresaola E, Nappi O, Viale G, Rosai J: Review article: pulmonary sarcomatoid carcinomas: a practical overview. Int J Surg Pathol. 2010, 18: 103-120. 10.1177/1066896908330049.CrossRefPubMed Pelosi G, Sonzogni A, De Pas T, Galetta D, Veronesi G, Spaggiari L, Manzotti M, Fumagalli C, Bresaola E, Nappi O, Viale G, Rosai J: Review article: pulmonary sarcomatoid carcinomas: a practical overview. Int J Surg Pathol. 2010, 18: 103-120. 10.1177/1066896908330049.CrossRefPubMed
3.
go back to reference Beasley MB, Brambilla E, Travis WD: The 2004 World Health Organization classification of lung tumors. Semin Roentgenol. 2005, 40: 90-97. 10.1053/j.ro.2005.01.001.CrossRefPubMed Beasley MB, Brambilla E, Travis WD: The 2004 World Health Organization classification of lung tumors. Semin Roentgenol. 2005, 40: 90-97. 10.1053/j.ro.2005.01.001.CrossRefPubMed
4.
go back to reference Franks TJ, Galvin JR: Sarcomatoid carcinoma of the lung: histologic criteria and common lesions in the differential diagnosis. Arch Pathol Lab Med. 2010, 134: 49-54.PubMed Franks TJ, Galvin JR: Sarcomatoid carcinoma of the lung: histologic criteria and common lesions in the differential diagnosis. Arch Pathol Lab Med. 2010, 134: 49-54.PubMed
5.
go back to reference Nakajima M, Kasai T, Hashimoto H, Iwata Y, Manabe H: Sarcomatoid carcinoma of the lung: a clinicopathologic study of 37 cases. Cancer. 1999, 86: 608-616. 10.1002/(SICI)1097-0142(19990815)86:4<608::AID-CNCR9>3.0.CO;2-1.CrossRefPubMed Nakajima M, Kasai T, Hashimoto H, Iwata Y, Manabe H: Sarcomatoid carcinoma of the lung: a clinicopathologic study of 37 cases. Cancer. 1999, 86: 608-616. 10.1002/(SICI)1097-0142(19990815)86:4<608::AID-CNCR9>3.0.CO;2-1.CrossRefPubMed
6.
go back to reference Pelosi G, Fraggetta F, Nappi O, Pastorino U, Maisonneuve P, Pasini F, Iannucci A, Solli P, Musavinasab HS, De Manzoni G, Terzi A, Viale G: Pleomorphic carcinomas of the lung show a selective distribution of gene products involved in cell differentiation, cell cycle control, tumor growth, and tumor cell motility: a clinicopathologic and immunohistochemical study of 31 cases. Am J Surg Pathol. 2003, 27: 1203-1215. 10.1097/00000478-200309000-00003.CrossRefPubMed Pelosi G, Fraggetta F, Nappi O, Pastorino U, Maisonneuve P, Pasini F, Iannucci A, Solli P, Musavinasab HS, De Manzoni G, Terzi A, Viale G: Pleomorphic carcinomas of the lung show a selective distribution of gene products involved in cell differentiation, cell cycle control, tumor growth, and tumor cell motility: a clinicopathologic and immunohistochemical study of 31 cases. Am J Surg Pathol. 2003, 27: 1203-1215. 10.1097/00000478-200309000-00003.CrossRefPubMed
7.
go back to reference Brambilla E, Travis WD, Colby TV, Corrin B, Shimosato Y: The new World Health Organization classification of lung tumours. Eur Respir J. 2001, 18: 1059-1068. 10.1183/09031936.01.00275301.CrossRefPubMed Brambilla E, Travis WD, Colby TV, Corrin B, Shimosato Y: The new World Health Organization classification of lung tumours. Eur Respir J. 2001, 18: 1059-1068. 10.1183/09031936.01.00275301.CrossRefPubMed
8.
go back to reference Koss MN, Hochholzer L, Frommelt RA: Carcinosarcomas of the lung: a clinicopathologic study of 66 patients. Am J Surg Pathol. 1999, 23: 1514-1526. 10.1097/00000478-199912000-00009.CrossRefPubMed Koss MN, Hochholzer L, Frommelt RA: Carcinosarcomas of the lung: a clinicopathologic study of 66 patients. Am J Surg Pathol. 1999, 23: 1514-1526. 10.1097/00000478-199912000-00009.CrossRefPubMed
9.
go back to reference Chang YL, Lee YC, Shih JY, Wu CT: Pulmonary pleomorphic (spindle) cell carcinoma: peculiar clinicopathologic manifestations different from ordinary non-small cell carcinoma. Lung Cancer. 2001, 34: 91-97.CrossRefPubMed Chang YL, Lee YC, Shih JY, Wu CT: Pulmonary pleomorphic (spindle) cell carcinoma: peculiar clinicopathologic manifestations different from ordinary non-small cell carcinoma. Lung Cancer. 2001, 34: 91-97.CrossRefPubMed
10.
go back to reference Mochizuki T, Ishii G, Nagai K, Yoshida J, Nishimura M, Mizuno T, Yokose T, Suzuki K, Ochiai A: Pleomorphic carcinoma of the lung: clinicopathologic characteristics of 70 cases. Am J Surg Pathol. 2008, 32: 1727-1735. 10.1097/PAS.0b013e3181804302.CrossRefPubMed Mochizuki T, Ishii G, Nagai K, Yoshida J, Nishimura M, Mizuno T, Yokose T, Suzuki K, Ochiai A: Pleomorphic carcinoma of the lung: clinicopathologic characteristics of 70 cases. Am J Surg Pathol. 2008, 32: 1727-1735. 10.1097/PAS.0b013e3181804302.CrossRefPubMed
11.
go back to reference Martin LW, Correa AM, Ordonez NG, Roth JA, Swisher SG, Vaporciyan AA, Walsh GL, Rice DC: Sarcomatoid carcinoma of the lung: a predictor of poor prognosis. Ann Thorac Surg. 2007, 84: 973-980. 10.1016/j.athoracsur.2007.03.099.CrossRefPubMed Martin LW, Correa AM, Ordonez NG, Roth JA, Swisher SG, Vaporciyan AA, Walsh GL, Rice DC: Sarcomatoid carcinoma of the lung: a predictor of poor prognosis. Ann Thorac Surg. 2007, 84: 973-980. 10.1016/j.athoracsur.2007.03.099.CrossRefPubMed
12.
go back to reference Venissac N, Pop D, Lassalle S, Berthier F, Hofman P, Mouroux J: Sarcomatoid lung cancer (spindle/giant cells): an aggressive disease?. J Thorac Cardiovasc Surg. 2007, 134: 619-623. 10.1016/j.jtcvs.2007.05.031.CrossRefPubMed Venissac N, Pop D, Lassalle S, Berthier F, Hofman P, Mouroux J: Sarcomatoid lung cancer (spindle/giant cells): an aggressive disease?. J Thorac Cardiovasc Surg. 2007, 134: 619-623. 10.1016/j.jtcvs.2007.05.031.CrossRefPubMed
13.
go back to reference Rossi G, Cavazza A, Sturm N, Migaldi M, Facciolongo N, Longo L, Maiorana A, Brambilla E: Pulmonary carcinomas with pleomorphic, sarcomatoid, or sarcomatous elements: a clinicopathologic and immunohistochemical study of 75 cases. Am J Surg Pathol. 2003, 27: 311-324. 10.1097/00000478-200303000-00004.CrossRefPubMed Rossi G, Cavazza A, Sturm N, Migaldi M, Facciolongo N, Longo L, Maiorana A, Brambilla E: Pulmonary carcinomas with pleomorphic, sarcomatoid, or sarcomatous elements: a clinicopathologic and immunohistochemical study of 75 cases. Am J Surg Pathol. 2003, 27: 311-324. 10.1097/00000478-200303000-00004.CrossRefPubMed
14.
go back to reference Ito K, Oizumi S, Fukumoto S, Harada M, Ishida T, Fujita Y, Harada T, Kojima T, Yokouchi H, Nishimura M, Hokkaido Lung Cancer Clinical Study Group: Clinical characteristics of pleomorphic carcinoma of the lung. Lung Cancer. 2010, 68: 204-210. 10.1016/j.lungcan.2009.06.002.CrossRefPubMed Ito K, Oizumi S, Fukumoto S, Harada M, Ishida T, Fujita Y, Harada T, Kojima T, Yokouchi H, Nishimura M, Hokkaido Lung Cancer Clinical Study Group: Clinical characteristics of pleomorphic carcinoma of the lung. Lung Cancer. 2010, 68: 204-210. 10.1016/j.lungcan.2009.06.002.CrossRefPubMed
15.
go back to reference Kaira K, Endo M, Abe M, Nakagawa K, Ohde Y, Okumura T, Takahashi T, Murakami H, Tsuya A, Nakamura Y, Naito T, Hayashi I, Kondo H, Nakajima T, Yamamoto N: Biologic correlates of (1) F-FDG uptake on PET in pulmonary pleomorphic carcinoma. Lung Cancer. 2011, 71: 144-150. 10.1016/j.lungcan.2010.05.021.CrossRefPubMed Kaira K, Endo M, Abe M, Nakagawa K, Ohde Y, Okumura T, Takahashi T, Murakami H, Tsuya A, Nakamura Y, Naito T, Hayashi I, Kondo H, Nakajima T, Yamamoto N: Biologic correlates of (1) F-FDG uptake on PET in pulmonary pleomorphic carcinoma. Lung Cancer. 2011, 71: 144-150. 10.1016/j.lungcan.2010.05.021.CrossRefPubMed
16.
go back to reference Pelosi G, Melotti F, Cavazza A, Rossi G, Maisonneuve P, Graziano P, Barbareschi M, Nakatani Y, Papotti M: A modified Vimentin histological score helps recognize pulmonary sarcomatoid carcinoma in small biopsy samples. Anticancer Res. 2012, 32: 1463-1474.PubMed Pelosi G, Melotti F, Cavazza A, Rossi G, Maisonneuve P, Graziano P, Barbareschi M, Nakatani Y, Papotti M: A modified Vimentin histological score helps recognize pulmonary sarcomatoid carcinoma in small biopsy samples. Anticancer Res. 2012, 32: 1463-1474.PubMed
17.
go back to reference Kaira K, Horie Y, Ayabe E, Murakami H, Takahashi T, Tsuya A, Nakamura Y, Naito T, Endo M, Kondo H, Nakajima T, Yamamoto N: Pulmonary pleomorphic carcinoma: a clinicopathological study including EGFR mutation analysis. J Thorac Oncol. 2010, 5: 460-465. 10.1097/JTO.0b013e3181ce3e3c.CrossRefPubMed Kaira K, Horie Y, Ayabe E, Murakami H, Takahashi T, Tsuya A, Nakamura Y, Naito T, Endo M, Kondo H, Nakajima T, Yamamoto N: Pulmonary pleomorphic carcinoma: a clinicopathological study including EGFR mutation analysis. J Thorac Oncol. 2010, 5: 460-465. 10.1097/JTO.0b013e3181ce3e3c.CrossRefPubMed
18.
go back to reference Leone A, Graziano P, Gasbarra R, Paone G, Cardillo G, Mancuso A, De Marinis F, Ricciardi S, Portalone L, Pisa R: Identification of EGFR mutations in lung sarcomatoid carcinoma. Int J Cancer. 2010, 128: 732-735.CrossRef Leone A, Graziano P, Gasbarra R, Paone G, Cardillo G, Mancuso A, De Marinis F, Ricciardi S, Portalone L, Pisa R: Identification of EGFR mutations in lung sarcomatoid carcinoma. Int J Cancer. 2010, 128: 732-735.CrossRef
19.
go back to reference Italiano A, Cortot AB, Ilie M, Martel-Planche G, Fabas T, Pop D, Mouroux J, Hofman V, Hofman P, Pedeutour F: EGFR and KRAS status of primary sarcomatoid carcinomas of the lung: Implications for anti-EGFR treatment of a rare lung malignancy. Int J Cancer. 2009, 125: 2479-2482. 10.1002/ijc.24610.CrossRefPubMed Italiano A, Cortot AB, Ilie M, Martel-Planche G, Fabas T, Pop D, Mouroux J, Hofman V, Hofman P, Pedeutour F: EGFR and KRAS status of primary sarcomatoid carcinomas of the lung: Implications for anti-EGFR treatment of a rare lung malignancy. Int J Cancer. 2009, 125: 2479-2482. 10.1002/ijc.24610.CrossRefPubMed
20.
go back to reference Tsao AS, Wei W, Kuhn E, Spencer L, Solis LM, Suraokar M, Lee JJ, Hong WK, Wistuba II: Immunohistochemical over expression of platelet-derived growth factor receptor–beta (PDGFR-β) is associated with PDGFRB gene copy number gain in sarcomatoid Non–small-cell lung cancer. Clin Lung Cancer. 2011, 12: 369-374. 10.1016/j.cllc.2011.02.002.PubMedCentralCrossRefPubMed Tsao AS, Wei W, Kuhn E, Spencer L, Solis LM, Suraokar M, Lee JJ, Hong WK, Wistuba II: Immunohistochemical over expression of platelet-derived growth factor receptor–beta (PDGFR-β) is associated with PDGFRB gene copy number gain in sarcomatoid Non–small-cell lung cancer. Clin Lung Cancer. 2011, 12: 369-374. 10.1016/j.cllc.2011.02.002.PubMedCentralCrossRefPubMed
Metadata
Title
Pulmonary sarcomatoid carcinoma: a clinicopathologic study and prognostic analysis of 51 cases
Authors
Si-Yuan Huang
Shu-Jing Shen
Xing-Ya Li
Publication date
01-12-2013
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2013
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-11-252

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