Xiao Congjia, Yang Xudong, Hao Jianqi, Guo Chenglin, Pu Qiang, Liu Lunxu
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China.
West China School of Medicine, Sichuan University, Chengdu, China.
J Thorac Dis. 2021 Feb;13(2):893-905. doi: 10.21037/jtd-20-2826.
Pulmonary sarcomatoid carcinoma (PSC) is a rare type of non-small cell lung cancer (NSCLC). Metastases are often detected at the first diagnosis. Despite high rates of distant metastasis, there is insufficient data describing the characteristics of PSC metastasis.
We performed a Surveillance, Epidemiology, and End Results (SEER) database-based analysis of clinicopathological features and prognosis of distant metastasis in PSC patients. Data queried for this analysis included PSC patients in the database between 2010 and 2016.
A total of 934 patients met the criteria for inclusion in the analysis and included, at the time of diagnosis, 512 (54.8%) patients with metastasis, including bone (n=152; 16.3%), brain (n=108; 11.6%), liver (n=70; 7.5%), lung (n=142; 15.2%) metastases. Binary logistic regression showed that patients with giant cell carcinoma [odds ratio (OR) 4.023, 95% confidence interval (CI): 2.113-7.661, P<0.001] and spindle cell carcinoma (OR 3.151, 95% CI: 1.699-5.843, P<0.001) were associated with metastasis. Log-rank test and Kaplan-Meier plots indicated poor prognosis in metastatic patients [the 1-, 3-, and 5-year overall survival (OS) rates were 14.1%, 5.5%, and 4.8%, respectively]. Multivariable analysis showed younger and chemotherapy as improved prognostic factors of PSC patients with single metastasis site.
The SEER database-based analysis revealed the clinical features of distant metastasis of PSC and showed that different histological types posed distinct metastasis potential. Besides, age and chemotherapy were the independent prognostic factors of PSC patients with single metastasis site.
肺肉瘤样癌（PSC）是一种罕见的非小细胞肺癌（NSCLC）类型。在首次诊断时常常检测到转移。尽管远处转移率很高，但描述PSC转移特征的数据并不充分。
我们基于监测、流行病学和最终结果（SEER）数据库对PSC患者远处转移的临床病理特征和预后进行了分析。本次分析查询的数据包括2010年至2016年数据库中的PSC患者。
共有934例患者符合纳入分析的标准，其中诊断时512例（54.8%）有转移，包括骨转移（n = 152；16.3%）、脑转移（n = 108；11.6%）、肝转移（n = 70；7.5%）、肺转移（n = 142；15.2%）。二元逻辑回归显示，巨细胞癌患者[比值比（OR）4.023，95%置信区间（CI）：2.113 - 7.661，P < 0.001]和梭形细胞癌患者（OR 3.151，95% CI：1.699 - 5.843，P < 0.001）与转移相关。对数秩检验和Kaplan - Meier曲线表明转移患者预后较差[1年、3年和5年总生存率（OS）分别为14.1%、5.5%和4.8%]。多变量分析显示年龄较小和化疗是PSC单转移部位患者预后改善的因素。
基于SEER数据库的分析揭示了PSC远处转移的临床特征，并表明不同组织学类型具有不同的转移潜能。此外，年龄和化疗是PSC单转移部位患者的独立预后因素。
