Steuer Conor E, Behera Madhusmita, Liu Yuan, Fu Chao, Gillespie Theresa W, Saba Nabil F, Shin Dong M, Pillai Rathi N, Pakkala Suchita, Owonikoko Taofeek K, Khuri Fadlo R, Ramalingam Suresh S
Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA.
Department of Biostatistics & Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA.
Clin Lung Cancer. 2017 May;18(3):286-292. doi: 10.1016/j.cllc.2016.11.016. Epub 2016 Dec 7.
Pulmonary sarcomatoid carcinoma (PSC) is a grouping of 5 rare non-small-cell lung cancer (NSCLC) subtypes. We studied the clinical characteristics and outcomes of PSC utilizing the National Cancer Data Base (NCDB), an oncology outcomes database.
The NCDB lung cancer database was queried from 1998 to 2011 for PSC using ICD-O-3 codes. Data were extracted for patient demographics, tumor pathology, treatment, and outcomes. Overall survival (OS) data were available for patients diagnosed from 1998 to 2006 and comorbidity data from 2003 to 2011. Univariate association with covariates between PSC and other forms of NSCLC was assessed by the chi-square test or ANOVA, as appropriate.
Of the 1,547,531 NSCLC patients in the NCDB from 1998 to 2011, 7965 were identified with PSC (0.5%). PSC patients had a median age of 70 years, 59% were men, and 89% were white. At presentation, 18% had American Joint Committee on Cancer stage I disease, 10% stage II, 24% stage III, and 48% stage IV. The median OS for stage I-II PSC was 16.9 months, 5.8 months for stage III, and 5.4 months for stage IV. There was a higher risk of death on multivariate analysis for PSC patients compared to other histologic subtypes of NSCLC in all patients (hazard ratio = 1.34 (95% confidence interval, 1.20-1.48) P < .001) and in propensity score-matched subsets (hazard ratio = 1.34; 95% confidence interval, 1.15-1.56; P < .001).
PSC is a rare histologic subtype of NSCLC, accounting for 0.5% of all lung cancers. The disease of patients with PSC has aggressive clinical characteristics and an inferior survival outcome relative to other histologic subtypes of NSCLC.
肺肉瘤样癌（PSC）是一组5种罕见的非小细胞肺癌（NSCLC）亚型。我们利用国家癌症数据库（NCDB，一个肿瘤学结局数据库）研究了PSC的临床特征和结局。
使用ICD - O - 3编码在1998年至2011年期间查询NCDB肺癌数据库中的PSC。提取患者人口统计学、肿瘤病理学、治疗和结局的数据。1998年至2006年诊断的患者可获得总生存（OS）数据，2003年至2011年的合并症数据。根据情况，通过卡方检验或方差分析评估PSC与其他形式NSCLC之间协变量的单变量关联。
在1998年至2011年NCDB中的1,547,531例NSCLC患者中，7965例被确诊为PSC（0.5%）。PSC患者的中位年龄为70岁，59%为男性，89%为白人。初诊时，18%为美国癌症联合委员会I期疾病，10%为II期，24%为III期，48%为IV期。I - II期PSC的中位OS为16.9个月，III期为5.8个月，IV期为5.4个月。在多变量分析中，与其他组织学亚型的NSCLC相比，PSC患者在所有患者中死亡风险更高（风险比 = 1.34（95%置信区间，1.20 - 1.48）P <.001），在倾向评分匹配亚组中也是如此（风险比 = 1.34；95%置信区间，1.15 - 1.56；P <.001）。
PSC是NSCLC一种罕见的组织学亚型，占所有肺癌的0.5%。相对于其他组织学亚型的NSCLC，PSC患者的疾病具有侵袭性临床特征和较差的生存结局。
