Diagnosis,Treatment And Prognostic Analyses Of Pulmonary Sarcomatoid Carcinoma(PSC)

Objective The aim of this study was to explore the diagnosis,treatment and prognostic factors of pulmonary sarcomatoid carcinoma(PSC).Methods The data of 129 cases with PSC,that underwent surgical excision in Cancer Hospital of Chinese Academy of Medical Sciences,from July 2005 to June 2017,were reviewed retrospectively.The prognostic factors were analyzed in univariate and multivariate analysis,including gender,age,smoking history,pathological subtypes,stage,visceral pleura metastasis,wall pleura metastasis,maximum diameter of tumors,lymph node metastasis and chemotherapy,etc.By the end of follow-up,76 patients died and 53 survived.All analysis were performed by SPSS 25.0.Kaplan-Meier method was used for survival analysis and univariate analysis.Log-rank method was used to test survival differences between the survival curves.Cox proportional risk regression model was used for multivariate analysis of different prognostic factors.A p-value lower than 0.05 was considered statistically significant.Results 1.The cumulative survival rates in 1-,3-and 5-year were 62%,40.4%and 37.2%,respectively.The 5-year survival rates for stage ?,?,? and IV were 95.2%,42.1%,19.2%and 0%,respectively.2.Univariate analysis showed that the tumor stage(P<0.001),the wall pleura metastasis(P=0.001),the maximum diameter of the tumor(P<0.001),lymph node metastasis(P=0.008),and visceral pleura metastasis(P=0.004)were prognostic factors.Multivariate analysis revealed that TNM stage(P=0.000)and visceral pleura metastasis(P=0.014)were independent prognostic factors.3.In phase ? PSC patients,Univariate analysis showed adjuvant chemotherapy(P<0.001),visceral pleura metastasis(P=0.034),and wall pleura metastasis(P=0.033)were prognostic factors.Multivariate analysis revealed that adjuvant chemotherapy was an independent prognostie factor(P=0.001,HR=0.256).Conclusions 1.TNM stage and visceral pleura metastasis were independent prognostic factors for PSC.2.Adjuvant chemotherapy was an independent prognostic factor for phase? PSC,reduced the risk of death.3.Whether chemotherapy can bring survival benefits for patients with stage ? and stag ? is not clear.