| Background:Pulmonary sarcomatoid carcinoma is a rare malignant tumor of the lung with a high degree of malignancy.The most common clinical researches are case reports or database analysis,and there are few large-scale retrospective studies of single centers in China.By retrospective analysis of the clinical data and survival of patients with pulmonary sarcomatoid carcinoma in our hospital,the clinical characteristics and prognostic factors of patients with pulmonary sarcomatoid carcinoma were summarized.Methods:119 patients with sarcomatoid carcinoma of lung who received treatment in Cancer Hospital of Chinese Academy of Medical Sciences from January 1,2006 to December 31,2015 were retrospectively analyzed.Patient information was obtained through medical records collected from the hospital information system,including:gender,age,body mass index,symptoms,family history of malignant tumor,smoking history,tumor size,tumor site,tumor maximum diameter,tumor TNM stage,lymph node status,histopathological type,surgical method,postoperative chemotherapy or not,etc.Patients were asked about their survival and survival status by telephone.Univariate and multivariate analyses were performed on the variables,and Kaplan-Meier was used to calculate the effects of the above factors on 1-year,3-year,5-year and overall survival of the patients.Results:Pulmonary Sarcomatoid carcinoma was most common in male patients(94,79%)with a history of smoking.The median age was 60.67 ± 10.50 years old(26-89 years old).Patients did not have specific clinical symptoms and the absolute majority of patients presented with respiratory symptoms(n=82/119).Pulmonary sarcomatoid carcinoma is difficult to be identified by biopsy puncture or intraoperative freezing pathology.Pleomorphic carcinoma is the common pathological type.Pulmonary Sarcomatoid carcinoma mostly presents in the upper lobes of both lungs,and the majority of patients undergo surgical treatment,with lobectomy and pneumonectomy being the main surgical procedures.As for whether patients with advanced stage need to receive adjuvant chemotherapy after surgery,this study showed that postoperative adjuvant chemotherapy did not significantly improve the long-term prognosis of patients.In the study,the median overall survival time of patients with pulmonary sarcomatoid carcinoma was 17.47 months(7.93-62.53 months),with 1-,3-,and 5-year survival rates of 61.3%,34.5%,and 31.9%.respectively.The survival curve analysis showed that TNM staging,T-staging,N-staging and M-staging of the tumor had a significant effect on the overall survival,1-year,3-year and 5-year survival of the patients(p<0.05).The prognosis with lymph node metastasis was worse than that without lymph node metastasis,where the prognosis was worse with multiple lymph node metastasis than with single lymph node metastasis,and the more the number and percentage of lymph node metastasis,the worse the prognosis(p<0.05).Other clinical features,tumor characteristics and treatment did not significantly affect the prognosis of patients(p>0.05).Conclusion:The overall prognosis of patients with pulmonary sarcomatoid carcinoma was poor,and the T-stage,N-stage,and M-stage of the tumor were the main factors affecting the prognosis of patients.At present,there are few clinical and basic studies on PSC,which leads to the lack of understanding of clinicians about PSC.In this paper,the clinical characteristics and prognostic factors of domestic PSC patients were obtained through regression analysis of a large sample of single center cases,which can play a certain clinical guiding role.BackgroundPulmonary Sarcomatoid Carcinoma(PSC)is a rare malignant tumor of lung.Due to its rarity,most studies are case reports or database articles,and there are fewer large-scale single-center studies to analyze its clinical features and prognostic influences.There are various ways to analyze and predict the prognosis of malignant tumors,including the use offormulas,web pages,nomogram,scoring systems and color scoring cards,among which nomogram is a more intuitive and convenient way of prediction and evaluation,and is also a way commonly used in clinical prediction model display.This study was based on PSC patients admitted to Chinese Academy of Medical Sciences,Cancer Hospital(hereinafter referred to as our institution)to construct a prognostic model for patients with pulmonary sarcomatoid carcinoma.PurposeThis study was conducted to construct a prognostic prediction model by analyzing the clinical characteristics and prognosis of patients with pulmonary sarcomatoid carcinoma who had been seen at our institution,and to present it using nomogram.MethodThe clinical data of 119 patients with pulmonary sarcomatoid carcinoma admitted to our institution from January 1,2006 to December 31,2015 were retrospectively analyzed.The training cohort was obtained by means of repeatable sampling,and the original sample was used as the validation cohort.The training cohort was used to construct the prognostic model for patients with PSC,and the validation cohort was used to verify the prognostic model.Stepwise regression and Least absolute shrinkage and selection(Lasso)were used to screen variables,and meaningful variables were selected to construct prognostic models based on univariate and multivariate analysis of the training cohort.The prediction models were subsequently evaluated using calibration curves and model decision curve analysis.ResultsThe variables that were screened out to have an impact on prognosis included body mass index(BMI),tumor-lymph nodes-metastasis(TNM)staging system and tumor T-stage.The constructed prediction models were tested using calibration curves and decision curves,showing the consistency of the models with the validation cohort,and also showing the feasibility of the models except in the validation cohort.ConclusionIn this paper,a prognostic model for patients with pulmonary sarcomatoid cancer was constructed based on the data of patients admitted to our center,and it was also the first prognostic model for patients with PSC based on the database of non-European and American populations.The constructed model showed that BMI,TNM stage of tumor and T stage of tumor had significant influence on the survival of patients with PSC.The model was validated by internal validation for its predictive ability.This model can be used as a good prognostic model for patients with PSC. |
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