Multimodality treatment including surgery for primary pulmonary sarcoma: Size does matter

J Surg Oncol. 2020 Sep;122(3):506-514. doi: 10.1002/jso.25979. Epub 2020 May 14.

Abstract

Background and objectives: Primary pulmonary sarcoma (PPS) accounts for less than 1.1% of all pulmonary tumors. Few outcome data are reported. We evaluated outcome and prognostic factors in our series.

Methods: We retrospectively reviewed all patients who underwent resection for PPS in our center from 2002 to 2018. Survival was calculated from the date of surgery until last follow-up. Impact on survival of gender, type of lung resection, completeness of resection, grade, size, and TNM staging for lung cancer and soft tissue sarcoma (STS) was assessed.

Results: Thirteen patients were included. Eight (61.5%) patients received neoadjuvant treatment. Median tumor size at diagnosis was 11.5 cm (1-30 cm). Type of lung resection was wedge (n = 2, 15%), lobectomy (n = 4, 31%), intrapericardial (n = 3, 23%), and extrapleural pneumonectomies (n = 4, 31%). In-hospital mortality was 8%. Overall 5-year survival was 60%. Median disease-free survival was 17 months. Tumor size was a predictor for survival (P = .02) and recurrence (P = .05). Gender (P = .04) and type of lung resection (P = .04) were predictors of survival. T stage for STS of trunk and extremity, and TNM stage for lung cancer were predictors for recurrence (P = .03 and P = .04, respectively).

Conclusion: Surgical resection within a multimodality therapy concept in highly selected patients can offer good long-term outcome.

Keywords: induction; lung sarcoma; multimodality treatment; primary pulmonary sarcoma; surgery.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Chemoradiotherapy, Adjuvant
  • Chemotherapy, Adjuvant
  • Disease-Free Survival
  • Female
  • Humans
  • Lung Neoplasms / pathology*
  • Lung Neoplasms / surgery*
  • Lung Neoplasms / therapy
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Staging
  • Pneumonectomy / methods
  • Retrospective Studies
  • Sarcoma / pathology*
  • Sarcoma / surgery*
  • Sarcoma / therapy
  • Survival Rate
  • Young Adult