Sarcomatoid carcinoma of the lung natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Trusha Tank, M.D.[2]

Overview

Sarcomatoid carcinoma of the lung progresses slowly and is followed by local invasion to lymph nodes, chest wall, pleura and distant metastasis. Sarcomatoid carcinoma of the lung is a type of non-small cell lung cancer. Non-small cell lung cancer is locally aggressive malignancy, which commonly occurs in adult patients between 65 to 74 years. Common sites of metastasis include the adrenal gland, bone, brain, and liver. Complications of non-small cell lung cancer include acute respiratory failure, respiratory acidosis, malignant pleural effusion, metastases, and pneumonia. The 3-year and 5-year survival rates for patients with sarcomatoid cancer of lung are 35.8% and 28.7%. Features associated with worse prognosis are presence of lymphatic invasion, location of lesion, and presence of regional or distant metastases. Prognosis is generally regarded as poor.

Natural History

The majority of patients with non-small cell lung cancer are initially asymptomatic.

• The symptoms of non-small cell lung cancer usually develop in adult patients between 65 to 74 years.
• Initially, patients complain of chronic cough, diaphoresis, and weight-loss.
• If left untreated, patients with non-small cell lung cancer may develop local invasion to lymph nodes and distant metastasis.
• Common sites of metastasis include the adrenal gland, bone, brain, and liver.

Complications

Common complications of non-small cell lung cancer, include:

Acute respiratory failure Respiratory acidosis Malignant pleural effusion Metastases Pneumonia

Prognosis

• Non-small cell lung cancer prognosis and recurrence depends on the origin of primary tumor, histological type, and stage.

• Non-small cell lung cancer prognosis is generally regarded as poor.
• Non-small cell lung cancer survival rate ranges from 1% to 52% (stage I to stage IV).
• The recurrence rate of non-small cell lung cancer is 24%.

• The development of complications is associated with worse prognosis. The median survival time of non-small cell lung cancer following a cancer-related complication, such as malignant pleural effusion, is approximately 1 to 3 months.
  • Features associated with worse prognosis, include:
    • Presence of lymphatic invasion
    • Unfavorable genetic expression profile
    • Location of lesion
    • Performance status
    • Presence of satellite lesions
    • Presence of regional or distant metastases
• The table below summarizes the 5-year survival rate according to non-small cell lung cancer stage:

Stage	5-year survival rate
IA	49%
IB	45%
IIA	30%
IIB	31%
IIIA	14%
IIIB	5%
IV	1%

References

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