Dataset Information

Clinical characteristics and prognostic factors of pulmonary sarcomatoid carcinoma.

ABSTRACT:

Background

Pulmonary sarcomatoid carcinoma (PSC) is a kind of rare lung cancer. We aim to analyze the clinical characteristics and prognostic factors of patients with PSC.

Methods

From January 1, 2006 to December 31, 2015, 119 patients in the Cancer Hospital Chinese Academy of Medical Sciences were diagnosed with PSC, and they received treatment. We retrospectively collected information on gender, age, body mass index (BMI), symptoms, family history, smoking history, tumor size, tumor location, tumor diameter, tumor-node-metastasis (TNM), pathological type, and other factors to analyze the relationship between these factors and 1-, 3-, 5-year, and overall survival (OS).

Results

Male patients who had a smoking history (n=76) comprised the main group of PSC. Median patient age was 60.67±10.50 years (range, 26-89 years). The majority of these patients (n=82) presented with respiratory symptoms. The median survival of patients who died of PSC was 11.87 months (6.38-21.48 months). The 1-, 3-, and 5-year survival rates were 61.3%, 34.5%, and 31.9%, respectively. Patients with a lower T stage and without lymph node metastasis and distant metastasis had a better OS (P<0.05). Other clinical characteristics and the difference in treatments did not influence the prognosis significantly (P>0.05).

Conclusions

PSC is a rare malignant neoplasm of the lung with poor prognosis. Surgery is a major therapeutic method for this disease entity. TNM-stage is the main factors affecting prognosis.

SUBMITTER: Zhao C

PROVIDER: S-EPMC9641323 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Publications

Clinical characteristics and prognostic factors of pulmonary sarcomatoid carcinoma.

Zhao Chenguang C Gao Shugeng S Xue Qi Q Tan Fengwei F Gao Yushun Y Mao Yousheng Y Wang Dali D Zhao Jun J Yang Ding D Hong Qian Q Mu Juwei J

Journal of thoracic disease 20221001 10

<h4>Background</h4>Pulmonary sarcomatoid carcinoma (PSC) is a kind of rare lung cancer. We aim to analyze the clinical characteristics and prognostic factors of patients with PSC.<h4>Methods</h4>From January 1, 2006 to December 31, 2015, 119 patients in the Cancer Hospital Chinese Academy of Medical Sciences were diagnosed with PSC, and they received treatment. We retrospectively collected information on gender, age, body mass index (BMI), symptoms, family history, smoking history, tumor size, t ...[more]

PMID: 36389311

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Project description:Background and objectivePulmonary sarcomatoid carcinoma (PSC) is a subset of non-small cell lung cancer (NSCLC) with highly malignant, aggressive, and heterogeneous features. Patients with this disease account for approximately 0.1-0.4% of lung cancer cases. The absence of comprehensive summaries on the basic biology and clinical treatments for PSC means there is limited systematic awareness and understanding of this rare disease. This paper provides an overview of the biological characteristics of PSC and systematically summarizes various treatment strategies available for patients with this disease.MethodsFor this narrative review, we have searched literature related to the basic biology and clinical treatment approaches of PSC by searching the PubMed database for articles published from July 16, 1990 to August 29, 2023. The following keywords were used: "pulmonary sarcomatoid carcinoma", "genetic mutations", "immune microenvironment", "hypoxia", "angiogenesis", "overall survival", "surgery", "radiotherapy", "chemotherapy", and "immune checkpoint inhibitors".Key content and findingsClassical PSC comprises epithelial and sarcomatoid components, with most studies suggesting a common origin. PSC exhibits a higher tumor mutational burden (TMB) and mutation frequency than other types of NSCLC. The tumor microenvironment (TME) of PSC is characterized by hypoxia, hypermetabolism, elevated programmed cell death protein 1/programmed cell death-ligand 1 expression, and high immune cell infiltration. Treatment strategies for advanced PSC are mainly based on traditional NSCLC treatments, but PSC exhibits resistance to chemotherapy and radiotherapy. The advancement of genome sequencing has introduced targeted therapies as an option for mutation-positive PSC cases. Moreover, due to the characteristics of the immune microenvironment of PSC, many patients positively respond to immunotherapy, demonstrating its potential for the management of PSC.ConclusionsAlthough several studies have examined and assessed the TME of PSC, these are limited in quantity and quality, presenting challenges for research into the clinical treatment strategies for PSC. With the emergence of new technologies and the advancement of clinical research, for example, savolitinib's clinical study for MET exon 14 skipping mutations positive PSC patients have shown promising outcomes, more in-depth studies on PSC are eagerly anticipated.

Project description:Pulmonary sarcomatoid carcinoma (PSC) is a group of five rare non-small cell lung cancer subtypes. In the present study, the clinical characteristics and outcomes of patients with PSC registered in the Surveillance, Epidemiology and End Results (SEER) database were investigated. For this purpose, data for patients with PSC (n=1,723) who received their initial diagnosis between 1988 and 2016 were collected from the SEER database. Survival analysis was performed using the Kaplan-Meier curves and the log-rank test. Subsequently, multivariate analyses with the Cox proportional hazards model were used to identify significant independent predictors. A nomogram model was established to predict survival performance using the concordance index (C-index). From the total cohort, patients with pulmonary blastoma demonstrated improved 1-year overall survival (OS) rate compared with other pathological types (P<0.001). The 2-year overall survival rates of the 'only radiotherapy' cohort and the 'no specific treatment' cohort were 9.1 and 5.4% (P<0.001), respectively. Radiotherapy significantly improved the OS rate in stage I-III patients with PSC (P<0.001) when stratified by stage. After matching the propensity scores, the 'surgery combined with radiotherapy' group comprised 156 patients and the 'surgery-only' group had 247 patients (1:1.6). However, no significant differences in prognosis were found between the 2 subgroups (P=0.052). The multivariate Cox analysis demonstrated that older age (≥76 years old), male, unmarried, pathological type, larger tumor size (≥56 mm), later tumor node metastasis stages and treatment modalities were independent prognostic factors. A nomogram model was established to predict the survival of patients with PSC. This model incorporated the seven aforementioned independent prognostic factors (C-index for survival, 0.75; 95% confidence interval, 0.74-0.76). Radiotherapy needs to considered for stage I-III patients with PSC who undergo radiation therapy without surgical resection.

Project description:Sarcomatoid carcinoma (SC) is regarded as a rare malignant neoplasm associated with poor outcomes. This study aimed to explore the epidemiological characteristics and prognostic factors of SC, and establish a clinical predictive model. The Surveillance, Epidemiology, and End Results database was used for data inquiry of patients with SC. Relevant population materials were used for age-adjusted incidence, limited-duration prevalence and prognostic analyses, and also for nomogram construction and validation. A total of 17,917 cases of SC were identified. Among them, 12,276 (68.52%) were women and 14,265 (79.62%) were white. Most cases occurred in the female genital system, accounting for 41.10% of all SCs. The median age at diagnosis was 68 years. The incidence and prevalence of SC increased substantially over time. The age-adjusted incidence increased from 0.31/100,000 in 1973 to 1.26/100,000 by 2014, a 4.06-fold change. Among site groups, the incidence of SC in the female genital and the respiratory system increased most significantly (P < 0.001). As for stage and grade, the incidence increased the most in distant and high-grade SC, respectively (P < 0.001). Moreover, the survival duration varied significantly by site, histology, stage and grade (P < 0.001). The multivariable analyses showed that the year of diagnosis, age, sex, race, grade, stage, and site were all significant prognostic factors (P < 0.001). Among these, stage and primary tumor site were the most valuable indicators of outcomes. Furthermore, a nomogram comprising age, histology, grade, stage and site were established to predict the 3-/5-year survival probability. The concordance indexes of the nomogram were 0.745 (95% confidence interval [CI]: 0.737-0.753) and 0.743 (95% CI: 0.728-0.756) for the internal and external validations, respectively. The calibration plot demonstrated satisfactory consistency between the actual and predicted outcomes in both the internal and external validations. In conclusion, increasing incidence and prevalence of SC was observed in our study, suggesting that SC is more prevalent than previously reported. Clinicians should be familiar with the characteristics of these tumors. Furthermore, the established nomogram could accurately predict the 3-/5-year survival rate of patients with SC, which may be of value for patient counselling and risk stratification.

Dataset Information

Clinical characteristics and prognostic factors of pulmonary sarcomatoid carcinoma.

Background

Methods

Results

Conclusions

Publications

Clinical characteristics and prognostic factors of pulmonary sarcomatoid carcinoma.

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