Prognostic factors and results after surgical treatment of primary sarcomas of the lung

doi:10.1016/S0003-4975(99)00398-7

The Annals of Thoracic Surgery

Volume 68, Issue 1, July 1999, Pages 227-231

https://doi.org/10.1016/S0003-4975(99)00398-7 Get rights and content

Abstract

Background. Primary sarcoma of the lung is a rare tumor. Our purpose was to study survival after resection and prognostic factors, which have been rarely reported.

Methods. In a 24-year period, we performed 20 complete resections and three exploratory thoracotomies only for primary lung sarcomas. One patient declined operation. Mean diameter of resected tumors was 9 cm (range, 4 to 18 cm). There were eight stage IB, eight stage IIB, one stage IIIA, and three stage IIIB. Sixty percent of patients with resected tumors received adjuvant therapy. Age, sex, resectability, tumor size, histologic cell type, stage, and adjuvant therapy were analyzed as predictors of survival.

Results. No postoperative deaths occurred. All 4 patients who had no resection died within 15 months. The 5- and 10-year actuarial survival after complete resection was 48%. The 5- and 10-year actuarial survival in stage IB was 83%, whereas the 4-year actuarial survival in stage IIB was 30% (p < 0.05). Complete resection and stage of disease were the sole significant prognostic factors.

Conclusions. Complete resection of primary sarcoma of the lung, when feasible, can achieve prolonged survival, although almost half of the patients died of metastasis within 2 years of operation. Adjuvant therapy needs to be investigated.

Section snippets

Patients and methods

In a 24-year period (1973 to 1997), 24 patients with primary sarcoma of the lung were consecutively treated in our thoracic department. There were 16 men and 8 women, with a mean age of 48 years (range, 14 to 73 years). Twenty patients presented with thoracic symptoms such as hemoptysis in eight cases, cough in six, chest pain in five, and hemopneumothorax in one, with associated systemic symptoms in six cases, such as fatigue, malaise, fever, or weight loss. Four patients had no symptoms, and

Results

There were no operative deaths. All 4 patients who did not have complete resection died within 15 months (median survival, 14 months). Ten of the 20 patients who had complete resection died of cancer, 9 of them within 2 years of operation and one 11 years after the operation. The site of metastases was the brain in three cases, the lung in one case, the brain and the lung in two cases, the bone in one case, and disseminated in three cases. Only one of these patients had an associated local

Comment

Sarcomas are mesenchymal tumors that rarely occur in the lung in comparison with some other anatomic sites, such as soft and bone tissues. They originate from the stromal elements of the bronchial or vascular wall or from the interstices of lung parenchyma. They usually expand toward lung parenchyma, giving well-circumscribed but unencapsulated tumors that occasionally expand intrabronchially. However, they rarely invade the bronchial epithelium, leading to exfoliating cells [11]. Dail [12]

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Original ArticlesPrognostic factors and results after surgical treatment of primary sarcomas of the lung

Abstract

Section snippets

Patients and methods

Results

Comment

J Thorac Cardiovasc Surg

J Thorac Surg

Chest

Bronchopulmonary leiomyosarcoma and fibrosarcomaa study of 32 cases and review of the literature

Cancer

Sarcomas of the lung

Mayo Clin Proc

Primary sarcoma of the lunga clinical study with long-term follow-up

Ann Thorac Surg

Original Articles
Prognostic factors and results after surgical treatment of primary sarcomas of the lung