Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
Surgery. 2012 Sep;152(3):397-402. doi: 10.1016/j.surg.2012.05.007. Epub 2012 Jun 26.
Sarcomatoid lung carcinomas are unusual, and reports from small single institution case series suggest poor survival rates. We sought to study the clinical characteristics of this form of non-small cell lung cancer using the Surveillance Epidemiology, End Results database.
The Surveillance, Epidemiology, and End Results database was queried for respiratory tract malignancies of sarcomatoid histology. The demographic information and oncologic characteristics of this population were examined. A propensity score-matched analysis of patients was performed to test the hypothesis that patients with sarcomatoid cancers undergoing lobectomies perform worse that those with other non-small cell lung cancers.
Of 878,810 patients with lung cancer, only 3,647 patients had a diagnosis of sarcomatoid cancer (0.4%). For the additional analyses of outcomes, only patients with lifetime incidence of a single cancer, known Surveillance, Epidemiology, and End Results historic stage and inpatient reporting were selected (n = 1,921). Demographics, tumor characteristics, and outcomes of these patients were described. Non-small cell lung cancer cohorts (with and without sarcomatoid cancer propensity-matched on age, gender, race, year of diagnosis, grade, and Surveillance, Epidemiology, and End Results historic stage) that underwent lobectomies or pneumonectomies were selected (n = 758). Univariate (hazard ratio, 1.60; 95% confidence interval, 1.31-1.97) and multivariate analysis (hazard ratio, 1.67; 95% confidence interval, 1.36-2.05) revealed a significantly worse overall survival for patients with sarcomatoid cancer compared to matched nonsarcomatoid lung cancer controls.
Sarcomatoid cancer is a rare form of lung malignancy with outcomes significantly worse than other forms of non-small cell lung cancer. Novel multimodality treatment strategies are necessary to improve outcomes of this disease.
肉瘤样肺癌较为罕见，来自小单中心病例系列的报告表明其生存率较低。我们使用监测、流行病学和最终结果数据库研究了这种非小细胞肺癌的临床特征。
对肉瘤样组织学的呼吸道恶性肿瘤的监测、流行病学和最终结果数据库进行了查询。检查了该人群的人口统计学信息和肿瘤特征。对接受肺叶切除术的肉瘤样癌患者进行倾向评分匹配分析，以检验肉瘤样癌患者的生存结果劣于其他非小细胞肺癌患者的假设。
在 878810 例肺癌患者中，仅有 3647 例（0.4%）诊断为肉瘤样癌。为了进行额外的预后分析，仅选择了具有单一癌症终生发生率、已知监测、流行病学和最终结果历史分期和住院报告的患者（n=1921）。描述了这些患者的人口统计学、肿瘤特征和预后。选择了接受肺叶切除术或全肺切除术的非小细胞肺癌队列（有无肉瘤样癌倾向匹配，按年龄、性别、种族、诊断年份、分级和监测、流行病学和最终结果历史分期）（n=758）。单因素（风险比，1.60；95%置信区间，1.31-1.97）和多因素分析（风险比，1.67；95%置信区间，1.36-2.05）显示，与匹配的非肉瘤样肺癌对照相比，肉瘤样癌患者的总生存明显较差。
肉瘤样癌是一种罕见的肺癌，其预后明显差于其他非小细胞肺癌。需要新的多模式治疗策略来改善这种疾病的预后。
