ISSN : 2146-3123
E-ISSN : 2146-3131

Prognostic Factors in Patients Undergoing Pulmonary Resection for Sarcomatoid Carcinomas of the Lung
Berker Özkan1, Eren Erdoğdu1, Salih Duman1, Fahmin Amirov1, Berk Çimenoğlu1, Yasemin Özlük2, Murat Kara1, Dilek Yılmazbayhan2, Alper Toker3
1Department of Thoracic Surgery, İstanbul University School of Medicine, İstanbul, Turkey
2Department of Pathology İstanbul University School of Medicine, İstanbul, Turkey
3Department of Cardiovascular and Thoracic Surgery, West Virginia University Heart and Vascular Institute, Morgantown, USA
DOI : 10.4274/balkanmedj.galenos.2020.2020.7.45

Introduction: Pulmonary sarcomatoid carcinomas are very rare lung neoplasms, and no consensus exists regarding the optimal treatment. The prognosis of sarcomatoid carcinomas has been reported to be unfavorable compared to non-small-cell lung cancers; however, prognostic factors in patients undergoing surgery for sarcomatoid carcinomas remain unclear.
Material and Methods: We designed a retrospective cross-sectional study in patients who underwent surgery for pulmonary sarcomatoid carcinomas and statistically analyzed the prognostic factors regarding clinicopathological features with respect to survival outcomes.
Results: We had a total of 44 patients with sarcomatoid carcinoma who had pulmonary resection. Sex distribution was 34 (77 %) males and 10 (22.7 %) females determined by declaration. The mean age of patients was 57.3 ± 16 with a median of 60 years The 5 year progression-free survival and overall survival rates were 59 % and 58 %, respectively. The 5 year survival rates were significantly different for tumors greater than 5 cm (p = 0.044), T status (p = 0.016), N status (p = 0.005) and pathologic TNM stage (p  0.0001). However, histologic subtype (p = 0.628) and adjuvant treatment (p = 0.804) did not have any significant effect on survival. Similarly, the significant prognostic factors in univariate analysis were tumor size (p = 0.085), T status (p = 0.005), N status (p = 0.028) and pathologic TNM stage (p = 0.0001). Multivariate analysis showed only T status (p = 0.058), N status (p = 0.018), and pathologic TNM stage (p = 0.019) as independent prognostic factors with statistical power of %87, %43.1 and %21.2.
Conclusion: Surgery appears as an optimal treatment with favorable outcomes for patients with pulmonary sarcomatoid carcinoma. Patients with small tumors at earlier stages are very likely to benefit from surgery, regardless of histologic subtype.

Keywords : Chemoradiotherapy, sarcomatoid carcinoma, surgery, survival
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