Clinical Features And Prognosis Of Pulmonary Sarcomatoid Carcinoma

Objective:To investigate the clinical features and prognosis of 76 patients with pulmonary sarcomatoid carcinoma(PSC)admitted to the First Affiliated Hospital of Medical School of Zhejiang University from January 2011 to December 2016.Methods:The study retrospectively reviewed the clinical,radiological,pathological characteristics and prognosis of 76 patients with PSC admitted to the First Affiliated Hospital of Medical School of Zhejiang University from January 2011 to December 2016 by consulting the electronic medical record system and telephone follow-up.SPSS 20.0 statistical software was used to analyze the data with Kaplan-Meier survival curve,Log-rank test and Cox proportional hazards model.The statistical significance was defined as p<0.05.Results:76 patients with PSC consisted of 61 men and 15 women;the average age was(62.9±9.8)years old.Cough(31 cases,40.8%),hemoptysis(29 cases,38.2%)and chest pain(12 cases,19.7%)were the main clinical manifestations.The average diameter of tumor was(4.7±2.3)cm,peripheral types(48 cases,63.2%),right lung(51 cases,67.1%)and upper lobe of the lung(46 cases,60.5%)were the common locations.The tumors usually had a smooth margin,showing an irregular annular enhancement around the area,but the enhancement of central part is not obvious.The main pathologic type was pleomorphic carcinoma;immunohistochemistry showed that vimentin and cytokeratin expressed positively.Tumor size,lymph node metastasis,distant metastasis,TNM staging and early surgical treatment(p<0.05)were prognostic factors for survival,while distant metastasis and TNM staging(p<0.001)were independent prognostic factors for patients.Conclusion:Clinical and radiological features were not specifically for PSC patients in our study;the diagnosis of PSC mainly relies on pathological examination.Early diagnosis and surgical treatment were the key to patients with PSC.Distant metastasis and TNM staging were independent prognostic factors.