Division of Thoracic Surgery, Saitama Cancer Center, Ina, Saitama, Japan.
Division of Pathology, Saitama Cancer Center, Ina, Saitama, Japan.
Ann Thorac Cardiovasc Surg. 2021 Feb 20;27(1):1-9. doi: 10.5761/atcs.oa.20-00018. Epub 2020 Jun 3.
To determine the outcomes and prognostic factors associated with pulmonary resection of pulmonary pleomorphic carcinoma (PPC).
During 2008-2017, 17 patients underwent pulmonary resection for primary PPC at the Saitama Cancer Center, Japan. We investigated clinicopathological characteristics and outcomes of these cases. Overall survival (OS) and disease-free survival (DFS) rates were determined using Kaplan-Meier method and compared using log-rank test. Univariate analysis was performed to identify prognostic factors.
The 5-year OS and DFS rates were 27.2% and 51.0%, respectively. The median follow-up period was 30.8±24.9 (3.6-92.8) months after pulmonary resections. Patients with disease-free interval (DFI) <1 year of resection had poorer prognosis than those without (p = 0.001). Patients with N2 status and adenocarcinoma components had significantly poorer disease-free prognosis than their counterparts (p = 0.021 and p = 0.019, respectively). Univariate analysis revealed that DFI <1 year was an unfavorable prognostic factor for OS (p = 0.005); N2 pathological status and presence of adenocarcinoma components were unfavorable prognostic factors for DFS (p = 0.038 and p = 0.036, respectively).
PPC patients with an adenocarcinoma component and N2 pathological status may have an earlier relapse and poorer prognosis than their counterparts. Further assessment of cases may help clarify the predictors of PPC.
确定与肺多形性癌（PPC）肺切除相关的结局和预后因素。
2008 年至 2017 年间，日本埼玉癌症中心对 17 例原发性 PPC 患者进行了肺切除术。我们调查了这些病例的临床病理特征和结局。使用 Kaplan-Meier 方法确定总生存率（OS）和无病生存率（DFS），并使用对数秩检验进行比较。进行单因素分析以确定预后因素。
5 年 OS 和 DFS 率分别为 27.2%和 51.0%。肺切除术后中位随访时间为 30.8±24.9（3.6-92.8）个月。无疾病间隔（DFI）<1 年的患者预后较无 DFI<1 年的患者差（p=0.001）。N2 状态和腺癌成分的患者DFS 预后明显较差（p=0.021 和 p=0.019）。单因素分析显示，DFI<1 年是 OS 的不利预后因素（p=0.005）；N2 病理状态和存在腺癌成分是 DFS 的不利预后因素（p=0.038 和 p=0.036）。
具有腺癌成分和 N2 病理状态的 PPC 患者可能比其他患者更早复发且预后较差。进一步评估病例可能有助于阐明 PPC 的预测因素。
