Surgical Outcomes and Risk Analysis of Primary Pulmonary Sarcoma

Yoshito Yamada, Tevfik Kaplan, Alex Soltermann, Isabelle Schmitt-Opitz, Didier Schneiter, Walter Weder, Ilhan Inci
Thoracic and Cardiovascular Surgeon 2019 September 9

BACKGROUND:  Primary pulmonary sarcoma (PPS) is a rare malignant lung neoplasm, and there is very little medical evidence about treatment of PPS. The aim of this study is to clarify the clinical characteristics and therapeutic outcome of patients who underwent surgical resection for PPS.

METHODS:  We retrospectively reviewed the records of patients who underwent surgical resection for PPS in our institution between 1995 and 2014. Cases who only underwent biopsy were excluded.

RESULTS:  A total of 24 patients (18 males, 6 females), with a median age of 60 (interquartile range: 44-67) years, were analyzed. The surgical procedures performed in these patients were pneumonectomy ( n  = 10), lobectomy ( n  = 11), and wedge resection ( n  = 3). Complete resection was achieved in 16 patients. The pathological stages (tumor, node, metastases lung cancer classification, 8th edition) of the patients were I ( n  = 4), II ( n  = 12), III ( n  = 2), and IV ( n  = 5), and there were four cases of lymph node metastasis. The 5-year overall survival rate of the patients was 50% (95% confidence interval [CI]: 29-72). Adverse prognostic factors for overall survival were incomplete resection (hazard ratio [HR]: 4.4, 95% CI: 2.1-42), advanced pathological stage (HR 14, 95% CI: 2.8-66), higher pathological grade (HR 4.5, 95% CI: 1.2-17), and tumor size ≥ 7 cm (HR 4.7, 95% CI: 1.1-21).

CONCLUSIONS:  Our series of PPS revealed that incomplete resection, advanced pathological stage, higher pathological grade, and tumor size were unfavorable factors for long-term survival.

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