Sarcomatoid carcinoma of the lung natural history, complications and prognosis

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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.[1]

  • The majority of patients with sarcomatoid carcinoma of the lung remain are initially asymptomatic.
  • Early clinical features include chronic cough, hemoptysis, dyspnea, weight loss and fatigue.[2]
  • If left untreated, patients with sarcomatoid carcinoma of the lung may develop local invasion and distant metastasis.
  • The majority of patients with central sarcomatoid carcinoma of the lung may develop distant metastasis to esophagus, jejunum, rectum, and kidney.
  • Sarcomatoid carcinoma of lung located in the periphery of lungs tends to be diagnosed later in the advanced stages with the large size and metastasis to the pleura and chest wall.

Complications

Common complications of sarcomatoid carcinoma of the lung, include:[1]

Prognosis

Prognosis of sarcomatoid carcinoma of the lung depends on the origin of the tumor, histological type, and stage.[1]

  • Prognosis of sarcomatoid carcinoma of the lung is generally poor.
  • The 3-year and 5-year survival rates for patients with sarcomatoid cancer of lung are 35.8 and 28.7%.[3]
  • Non-small cell lung cancer survival rate ranges from 1% to 52% (stage I to stage IV).

References

  1. ↑ 1.0 1.1 1.2 Soares M, Darmon M, Salluh JI, Ferreira CG, Thiéry G, Schlemmer B, Spector N, Azoulay E (2007). "Prognosis of lung cancer patients with life-threatening complications". Chest. 131 (3): 840–6. doi:10.1378/chest.06-2244. PMID 17356101.
  2. ↑ Travis WD; Brambilla E; Müller-Hermelink K; Harris C; Kleihues C; Sobin P. https://www.iarc.fr/wp-content/uploads/2018/07/BB10.pdf |chapterurl= missing title (help) (PDF). World Health Organization Classification of Tumours; Pathology and genetics of tumors of the lung, pleura, thymus, and heart. IARC Press. pp. 53–58. ISBN ISBN 92 832 2418 3 Check |isbn= value: invalid character (help).
  3. ↑ Roesel, Christian; Terjung, Sarah; Weinreich, Gerhard; Hager, Thomas; Chalvatzoulis, Eleftherios; Metzenmacher, Martin; Welter, Stefan (2016). "Sarcomatoid carcinoma of the lung: a rare histological subtype of non-small cell lung cancer with a poor prognosis even at earlier tumour stages". Interactive CardioVascular and Thoracic Surgery: ivw392. doi:10.1093/icvts/ivw392. ISSN 1569-9293.


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