Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, South Korea.
Oncology. 2011;81(3-4):206-13. doi: 10.1159/000333095. Epub 2011 Nov 9.
Sarcomatoid carcinoma of the lung is a very rare and aggressive subtype of non-small cell lung cancer. We explored the clinicopathologic characteristics and surgical outcome of this tumor.
Among 4,212 patients who underwent curative resection for non-small cell lung cancer from September 1994 to December 2009, 99 patients had sarcomatoid carcinoma. Medical records of patients were reviewed retrospectively.
The mean follow-up period was 16.07 months. Thirty-six patients had pathologic stage I disease, and 63 had more advanced disease. Surgery included 2 wedge resections, 67 lobectomies, 17 bilobectomies, and 13 pneumonectomies. There were 90 pleomorphic carcinomas, 6 spindle cell carcinomas, 1 giant cell carcinoma, 1 carcinosarcoma, and 1 pulmonary blastoma. Overall 5-year survival was 54.3%. Forty-three patients experienced recurrence and 42 of these died of the cancer. Pathologic T stage as defined by the 7th TNM staging system was significantly associated with survival and recurrence (p = 0.004 and 0.002, respectively). Mean positron emission tomography uptake was significantly higher than in other types of lung cancer (p < 0.0001).
Our results implied that surgery for sarcomatoid carcinoma must be carefully planned after extensive preoperative evaluation. Efforts should be made for accurate preoperative histological diagnosis of large peripheral tumor with exceedingly high positron emission tomography uptake.
肺肉瘤样癌是一种非常罕见且侵袭性强的非小细胞肺癌亚型。我们旨在探究该肿瘤的临床病理特征和手术治疗效果。
1994 年 9 月至 2009 年 12 月，共有 4212 例非小细胞肺癌患者接受了根治性切除术，其中 99 例为肉瘤样癌患者。我们回顾性分析了这些患者的病历资料。
平均随访时间为 16.07 个月。36 例患者为Ⅰ期病理分期，63 例患者为更晚期的病理分期。手术包括 2 例楔形切除术、67 例肺叶切除术、17 例双肺叶切除术和 13 例全肺切除术。90 例为多形性癌、6 例为梭形细胞癌、1 例为巨细胞癌、1 例癌肉瘤和 1 例肺胚细胞瘤。整体 5 年生存率为 54.3%。43 例患者出现复发，其中 42 例患者死于该肿瘤。第 7 版 TNM 分期系统中定义的病理 T 分期与生存和复发显著相关（p = 0.004 和 0.002）。与其他类型肺癌相比，肉瘤样癌的正电子发射断层扫描摄取值显著更高（p < 0.0001）。
我们的研究结果表明，对于肉瘤样癌患者，必须在进行广泛的术前评估后仔细规划手术。对于具有极高正电子发射断层扫描摄取值的大型外周肿瘤，应努力进行准确的术前组织学诊断。
