Clinicopathological characteristics and prognostic analysis of 94 patients with pulmonary sarcomatoid carcinoma

HE Cheng; XU Ke; LI Lailing; ZHANG Zhihong

doi:10.3969/j.issn.1009-0460.2024.08.005

Abstract：Objective To explore the clinicopathological characteristics,treatment,and prognosis of patients with primary pulmonary sarcomatoid carcinoma(PSC).Methods A retrospective analysis was conducted on the clinical data of 94 PSC patients from January 2014 to May 2023.The Kaplan-Meier method was used to calculate the overall survival(OS)and progression-free survival(PFS).Results Among the 94 PSC patients,there were 75 males and 19 females.At the time of diagnosis,the age ranged from 36 to 89 years,with a median age of 67 years.Seventy-six patients were smokers(81.0％).Fifty-eight cases(61.2％)had tumors larger than 5 cm in size.The tissues of 51 patients underwent genetic testing.The jump mutation in exon 14 of mesenchymal epithelial transition factor(MET)was the most frequently detected driver gene mutation(17.6％).Among the 45 patients who underwent surgical treatment,the median OS for those who received postoperative adjuvant chemotherapy was 21 months,while for those who did not receive postoperative adjuvant chemotherapy,it was 16 months.Among patients with MET 14 exon jump mutation,6 received targeted treatment with savolitinib,with the median PFS and OS of 6 and 11 months,respectively.After receiving chemotherapy combined with immune checkpoint inhibitors(ICIs)for advanced PSC patients,the median PFS was 8 months and the median OS was 16 months;The median PFS and OS of patients who only received chemotherapy were 2 months and 7 months,respectively.Conclusion For early PSC,surgery and postoperative adjuvant chemotherapy can maximize the survival benefits.For locally advanced or advanced patients,ICIs combined with chemotherapy or MET inhibitors may be the better treatment option.