BACKGROUND: Sarcomatoid cancer (SARC) of the lung is a rare histologic type of non-small cell lung cancer (NSCLC). Although believed to be associated with poor prognosis, its effect on survival and recurrence has not been well defined. Our goal was to determine the prognostic significance of SARC histology in patients undergoing pulmonary resection. METHODS: We retrospectively evaluated all patients who underwent pulmonary resection for NSCLC during a 20-year period at the University of Texas MD Anderson Cancer Center and compared recurrence and survival rates of patients with SARC with a cohort of patients with typical NSCLC. To account for known prognostic factors such as smoking status, age, gender, pathologic stage, and adjuvant therapy, we used one-to-one matching based on propensity scores. RESULTS: The study included 63 SARC patients and 1133 NSCLC patients with complete data. Propensity score matching identified 63 NSCLC patients that were similar to the 63 SARC patients from known clinical factors. The 5-year survival for SARC patients was 24.5% compared with 46.3% for NSCLC patients (p = 0.01); median time to recurrence was 11.3 months and 61.4 months, respectively (p = 0.001). CONCLUSIONS: Compared with other histologic subtypes, SARC behaves in an aggressive fashion. These tumors are frequently symptomatic, are locally advanced, and have higher rates of recurrence. Future investigation of novel treatment approaches is warranted. Nonsurgical treatment modalities may be appropriate for patients with clinically advanced disease.
BACKGROUND:Sarcomatoid cancer (SARC) of the lung is a rare histologic type of non-small cell lung cancer (NSCLC). Although believed to be associated with poor prognosis, its effect on survival and recurrence has not been well defined. Our goal was to determine the prognostic significance of SARC histology in patients undergoing pulmonary resection. METHODS: We retrospectively evaluated all patients who underwent pulmonary resection for NSCLC during a 20-year period at the University of Texas MD Anderson Cancer Center and compared recurrence and survival rates of patients with SARC with a cohort of patients with typical NSCLC. To account for known prognostic factors such as smoking status, age, gender, pathologic stage, and adjuvant therapy, we used one-to-one matching based on propensity scores. RESULTS: The study included 63 SARC patients and 1133 NSCLCpatients with complete data. Propensity score matching identified 63 NSCLCpatients that were similar to the 63 SARC patients from known clinical factors. The 5-year survival for SARC patients was 24.5% compared with 46.3% for NSCLCpatients (p = 0.01); median time to recurrence was 11.3 months and 61.4 months, respectively (p = 0.001). CONCLUSIONS: Compared with other histologic subtypes, SARC behaves in an aggressive fashion. These tumors are frequently symptomatic, are locally advanced, and have higher rates of recurrence. Future investigation of novel treatment approaches is warranted. Nonsurgical treatment modalities may be appropriate for patients with clinically advanced disease.
Authors: Anne S Tsao; Wei Wei; Elisabetta Kuhn; Loreto Spencer; Luisa M Solis; Milind Suraokar; J Jack Lee; Waun Ki Hong; Ignacio I Wistuba Journal: Clin Lung Cancer Date: 2011-05-17 Impact factor: 4.785
Authors: Jamie E Chaft; Camelia S Sima; Michelle S Ginsberg; James Huang; Mark G Kris; William D Travis; Christopher G Azzoli Journal: J Thorac Oncol Date: 2012-09 Impact factor: 15.609
Authors: Hee Seung Choi; Hyesil Seol; Il Yeong Heo; Chang Won Jung; Soo Youn Cho; Sunhoo Park; Jae Soo Koh; Seung-Sook Lee Journal: Korean J Pathol Date: 2012-12-26