Pulmonary Sarcomatoid Carcinoma: An Analysis of the National Cancer Data Base

• Published in: Clinical lung cancer Vol. 18; no. 3; pp. 286 - 292
• Main Authors: Steuer, Conor E, Behera, Madhusmita, Liu, Yuan, Fu, Chao, Gillespie, Theresa W, Saba, Nabil F, Shin, Dong M, Pillai, Rathi N, Pakkala, Suchita, Owonikoko, Taofeek K, Khuri, Fadlo R, Ramalingam, Suresh S
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2017
• Subjects: Aged; Carcinoma, Non-Small-Cell Lung - epidemiology; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - pathology; Continental Population Groups; Databases, Factual; Female; Hematology, Oncology and Palliative Medicine; Humans; Lung cancer; Lung Neoplasms - epidemiology; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Male; NCDB; Neoplasm Staging; NSCLC; Outcomes; Prevalence; Pulmonary/Respiratory; Retrospective Studies; Risk; Sarcoma - epidemiology; Sarcoma - mortality; Sarcoma - pathology; Sarcomatoid; Survival Analysis; United States - epidemiology; Sarcomatoid; NSCLC; Lung cancer; Outcomes; NCDB
• ISSN: 1525-7304; 1938-0690
• DOI: 10.1016/j.cllc.2016.11.016

Abstract Introduction Pulmonary sarcomatoid carcinoma (PSC) is a grouping of five rare non-small cell lung cancer (NSCLC) subtypes. We studied the clinical characteristics and outcomes of PSC utilizing the National Cancer Data Base (NCDB), an oncology outcomes database. Methods The NCDB lung cancer database was queried from 1998 to 2011 for PSC using ICD-O-3 codes. Data were extracted on patient demographics, tumor pathology, treatments, and outcomes. Overall survival (OS) data were available for patients diagnosed from 1998-2006 and co-morbidity data from 2003-2011. Univariate association with covariates between PSC and other forms of NSCLC was assessed using Chi-square test or ANOVA, where appropriate. Results Of the 1,547,531 NSCLC patients in the NCDB from 1998-2011, 7965 were identified with PSC (0.5%). PSC patients had a median age of 70, 59% male, and 89% Caucasian. At presentation, 18% were AJCC stage I, 10% stage II, 24% stage III, and 48% stage IV. The median OS for stage I-II PSC was 16.9 months, 5.8 months for stage III, and 5.4 months for stage IV. There was a higher risk of death on multivariate analysis for PSC patients in comparison to other histologic subtypes of NSCLC both in all patients (hazard ratio (HR) 1.34 (95% CI 1.20-1.48) p<0.001) and in a propensity score matched subsets (HR 1.34 (CI 1.15-1.56) p<0.001). Conclusions PSC is a rare histologic subtype of NSCLC accounting for 0.5% of all lung cancers. Patients with PSC have aggressive clinical characteristics and an inferior survival outcome relative to other histological subtypes of NSCLC.