2018 Volume 32 Issue 5 Pages 556-563
Background: Pulmonary pleomorphic carcinoma (PC) is a primary lung cancer associated with a poor prognosis. We assessed the prognosis and prognostic factors of patients with surgically resected pleomorphic carcinoma. Method: Thirty-one patients with pleomorphic carcinoma (1.8% primary lung carcinoma/2.0% non-small cell carcinoma) among 1,697 cases of resected primary lung carcinoma between January 2007 and February 2017 were retrospectively analyzed. Results: The 5-year overall survival (OS) was 37.6% (median: 23.4 months) and 5-year disease-free survival (DFS) was 33.6% (median: 11.3 month) in the 31 patients with pleomorphic carcinoma. Pleomorphic carcinoma was associated with a poorer prognosis than non-small cell cancer without pleomorphic carcinoma (Non-PC NSCLC), which was resected in the same period. When PC and Non-PC NSCLC were compared in each pathological stage (p-Stage), the prognosis associated with PC was not inferior in p-Stage I, but it was worse than in Non-PC NSCLC in p-Stage II-III. Log-rank tests showed that a tumor size≥4 cm and FDG PET-CT maximum standard uptake values (SUVmax) ≥15 were prognostic factors indicating a poor OS and DFS, and p-Stage≥II and pleural invasion were prognostic factors indicating a poor OS. Furthermore, adjuvant chemotherapy was not a prognostic factor. Conclusion: Pleomorphic carcinoma is lung cancer associated with an unfavorable prognosis except for p-Stage I. The adjuvant chemotherapy provided at present may not improve the prognosis of PC patients, and so a new treatment strategy is needed.
