Primary pulmonary sarcomas: etiology, clinical assessment and prognosis with a comparison to pulmonary carcinomas--a review of 41 cases and 394 other cases of the literature.

Primary sarcomas of the lungs occur at frequencies of 1:100, as compared with carcinomas reported in our retrospective studies covering 394 cases reported in the literature from 1957 to 1972 and 41 cases from 1957 to 1974. The average age was 45 years, the disease usually occurred between the ages of 35 and 65, the peak being between 45 and 60 years. Distribution between sexes was much the same as that seen in general. X-ray with rapid thoracotomy provided the best clinical results. The literature showed a postoperative survival time of 5 years in 19% and 44% of our own cases. The general metastasis, haematologenous and lymphogenous were more or less equal and recidive tendency in 7% essentially varied, as related to the single histological forms. Lymphosarcomas (28.6%) were the most frequent, the group of spindle-celled sarcomas, inclusive of leiomyosarcomas, occurred in 40%. Histological maturity of the tissues and the prognosis according to active therapy were in parallel. A comparison of 41 primary sarcomas of the lungs with the 192 cases of carcinomas seen in our clinic showed no connection between sarcomas of the lungs and smoking of cigarettes, pollution of the environment, industrial toxins or chronic bronchitis. These findings relate to the peripheral localization as well as to the lack of incidence among men, with regard to pulmonary adenocarcinomas. An overall view of the characteristics led to the assumption of a probable endogenous tumour. A summarization of the characteristics of pulmonary sarcomas and carcinomas revealed the role of primary sarcomas in the total complex of malignant tumours of the lungs.