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M. Paci
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P1.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 224)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.08-021 - Role of Surgery in Sarcomatoid Tumors of the Lung: A Multicentre Analysis (ID 44)
09:30 - 09:30 | Author(s): M. Paci
- Abstract
Background:
Sarcomatoid lung carcinoma (SaLC) is a very rare and aggressive subtype of non-small cell lung cancer (NSCLC). To better understand the long-term results after surgical treatment and the main prognostic factors of such rare entities, we have revisited the clinical records of patients affected by SaLC in a large multicentre surgical series.
Methods:
Among 6569 patients who underwent curative resection for NSCLC from 01/2003 to 12/2013 in 5 Institutions, 148 patients (2.2%) had sarcomatoid carcinoma. Clinical and pathological data were retrospectively reviewed. Kaplan-Meier method, log-rank test and Cox-regression analysis were used for the statistical analysis when indicated.
Results:
Mean age and male/female ratio were 66.6±9.9 yrs and 120/28, respectively. The main clinical, surgical and pathological features of the population are summarized in Table 1. Thirty-six pts (24.3%) had pathologic stage-I disease and 70 pts (47.3%) presented with mixed histological tumor (SaLC combined with NSCLC). The overall median and 5-year (LTS) survivals were 17 months and 11.3%, respectively. During follow-up, 101 patients (68.2%) experienced a relapse of disease (84 pts (57%) at distance). Log-rank analysis identified the administration of pre-op PET/CT scan (LTS: yes=17.9% vs no=5.5%; p=0.040), the surgical radicality (LTS: R0=13.2% vs R+=0%, p<0.001), the pStage (LTS: p-I=13.2%, p-II=10.6%, p-III=6.3%, p-IV=0%; p<0.001) as prognostic factors in SaLC patients. Finally, Cox regression analysis confirmed the administration of pre-op PET/CT scan (p=0.021), the surgical radicality (p<0.001) and the p-Stage (p=0.022) as independent prognostic factors in such cohort of patients.
Conclusion:
Primary SaLC presented a poor prognosis after surgical treatment (overall 5-yr survival=11.3%), even in early stages (LTS: 13.2% in pStage-I). Such results imply that the role of surgery for primary SaLC is questionable and eventually limited (after an accurate preoperative staging) to “early-stage” tumors only. In this framework, stronger efforts should be made for target therapies development for such rare entity. Figure 1
