[Clinical features and prognosis of pulmonary sarcomatoid carcinoma]

Objective: To investigate the clinical features and prognosis of patients with pulmonary sarcomatoid carcinoma (PSC). Methods: The study retrospectively reviewed the clinical, radiological, pathological characteristics and prognosis of 76 patients with PSC who were treated in the First Affiliated Hospital of Medical School of Zhejiang University from January 2011 to December 2016. Gender, age, smoking history, tumor location, tumor size, lymph node metastasis, distant metastasis, TNM staging and treatment methods were analyzed to determine the factors affecting the prognosis of PSC patients. Results: The 76 patients with PSC consisted of 61 men and 15 women, the average age was (62.9±9.8) years old. Cough (31 cases, 40.8%), hemoptysis (29 cases, 38.2%) and chest pain (15 cases, 19.7%) were the main clinical manifestations; the average diameter of tumor was (4.7±2.3) cm; the peripheral type (48 cases, 63.2%), right lung (51 cases, 67.1%) and upper lobe of the lung (46 cases, 60.5%) were the common locations. The tumors usually were with a smooth margin, showing an irregular annular enhancement around the area, but the central part of the tumors were not enhanced obviously. The main pathologic type was pleomorphic carcinoma, and immunohistochemistry showed that vimentin and cytokeratin were usually expressed.Tumor size, lymph node metastasis, distant metastasis, TNM staging and early surgical treatment (P<0.05) were prognostic factors for survival, and distant metastasis and TNM staging (P<0.001) were independent prognostic factors affecting the prognosis of patients. Conclusions: There are no specificity in the clinical and radiological features of PSC patients in our study, and the diagnosis of PSC depends mainly on pathological analysis. Distant metastasis and TNM staging are independent prognostic factors.