Gang Jin, Yan Qiao, Xiang Song, Zheng Li, Zhao Lujun
Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin, China.
Department of Medical Oncology, Second Hospital of Shanxi Medical University, Taiyuan, China.
Ann Transl Med. 2021 Jan;9(2):121. doi: 10.21037/atm-20-6213.
This study was conducted to identify the clinicopathological characteristics and survival outcomes of pulmonary sarcomatoid carcinoma (PSC), and to compare prognostic factors between elderly (≥65 years) and non-elderly (<65 years) patients.
The Surveillance, Epidemiology, and End Results (SEER) database was used to identify patients diagnosed with PSC between 2004 and 2016. The Kaplan-Meier method was used for overall survival (OS) and cancer-specific survival (CSS) analysis. The Cox proportional hazards model was used to detect independent prognostic factors. A propensity score matched (PSM) analysis was conducted to compare OS and CSS in elderly versus non-elderly PSC patients.
A total of 1,039 eligible cases were identified, with a median follow-up of 6 months. The 5-year OS and CSS rates were 12.3% and 18.7%, respectively, and the median survival was 6 months. Multivariate analysis revealed that female (HR =0.750, P<0.004), surgery (HR =0.484, P<0.001), chemotherapy (HR =0.504, P<0.001), and radiation (HR =0.801, P=0.041) were independent favorable prognostic factors. There was a significant difference in the OS and CSS rates between elderly and non-elderly patients after PSM (P=0.007 and P=0.017, respectively). In multivariate analysis, the predictors for OS in the elderly patients were gender, tumor stage, and chemotherapy, whereas in the non-elderly patients, the predictors were tumor stage, chemotherapy, and surgery.
The PSC patients in our study had poor survival outcomes. Comprehensive treatment, including surgery, chemotherapy, and radiotherapy, could improve patient prognosis. Elderly patients had different clinicopathological characteristics, compared to non-elderly patients.
本研究旨在确定肺肉瘤样癌（PSC）的临床病理特征和生存结果，并比较老年（≥65岁）和非老年（<65岁）患者的预后因素。
使用监测、流行病学和最终结果（SEER）数据库来识别2004年至2016年期间诊断为PSC的患者。采用Kaplan-Meier方法进行总生存（OS）和癌症特异性生存（CSS）分析。使用Cox比例风险模型检测独立预后因素。进行倾向评分匹配（PSM）分析以比较老年与非老年PSC患者的OS和CSS。
共识别出1039例符合条件的病例，中位随访时间为6个月。5年OS率和CSS率分别为12.3%和18.7%，中位生存期为6个月。多因素分析显示，女性（HR =0.750，P<0.004）、手术（HR =0.484，P<0.001）、化疗（HR =0.504，P<0.001）和放疗（HR =0.801，P=0.041）是独立的有利预后因素。PSM后老年和非老年患者的OS率和CSS率存在显著差异（分别为P=0.007和P=0.017）。在多因素分析中，老年患者OS的预测因素为性别、肿瘤分期和化疗，而非老年患者的预测因素为肿瘤分期、化疗和手术。
我们研究中的PSC患者生存结果较差。包括手术、化疗和放疗在内的综合治疗可改善患者预后。与非老年患者相比，老年患者具有不同的临床病理特征。
