Primary pulmonary sarcoma - treatment outcomes depending on the different types of radical operation

Janusz Gołota, Karolina Osowiecka, Tadeusz Orłowski
Polish Journal of Cardio-Thoracic Surgery 2019, 16 (1): 1-6

Introduction: Primary pulmonary sarcomas (PPS) are rare types of non-epithelial malignant tumors of the lungs (0.013-1.1% of all malignant lung tumors). The PPS can originate from mesenchymal elements of the bronchial wall, vessels or pulmonary stroma. Since the introduction of immunohistochemical and molecular diagnosis, a significant improvement in description and classification of sarcomas has been achieved. Nonetheless, sarcomas still remain a diagnostic and clinical problem.

Aim: To estimate factors which could have an influence on the overall survival (OS) and progression-free survival (PFS) of different types of radical operations (R0 ) for PPS.

Material and methods: Fourteen patients who underwent surgical radical treatment between 1994 and 2009 with a final diagnosis of PPS were analyzed.

Results: A group of 14 patients, treated with R0 operations (pneumonectomies, lobectomies, non-anatomical resections), were included in the analysis. Median OS of patients undergoing R0 operations was respectively: for pneumonectomy 7 months, lobectomy 20 months, non-anatomic resections 213 months. Patients subjected to non-anatomical resections had better prognosis than the others treated radically ( p < 0.05); however, this group of patients had the most local recurrences (3 patients - 50%). Statistical analysis did not show the influence of prognostic factors characteristic of PPS and soft tissue sarcoma (STS) on OS in the types of surgery performed.

Conclusions: There are no unambiguous factors affecting OS and PFS of patients who have undergone anatomical and non-anatomical resections. A large number of local recurrences in non-anatomical operations may indicate that PPS spread like lung cancer.

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