Clinical outcomes with perioperative chemotherapy in sarcomatoid carcinomas of the lung Journal Article
| Authors: | Chaft, J. E.; Sima, C. S.; Ginsberg, M. S.; Huang, J.; Kris, M. G.; Travis, W. D.; Azzoli, C. G. |
| Article Title: | Clinical outcomes with perioperative chemotherapy in sarcomatoid carcinomas of the lung |
| Abstract: | INTRODUCTION:: In patients with resected lung cancer, sarcomatoid carcinomas are reputed to carry a worse prognosis. Although generally felt to be chemo-refractory, little data are available about chemotherapy in these patients. We sought to determine the effect of perioperative chemotherapy in patients with completely resected sarcomatoid carcinomas of the lung. METHODS:: We reviewed the pathology reports of 4675 patients consecutively resected at Memorial Sloan-Kettering between 2000 and 2010. Charts and images were reviewed for patients with a histologic diagnosis of sarcomatoid carcinoma. Response to neoadjuvant chemotherapy was assessed radiographically. Kaplan-Meier disease-free probability (DFP) curves were compared for patients who did and did not receive perioperative chemotherapy, stratified by pathological stage. RESULTS:: Of the 4675 patients who underwent an R0 lung cancer resection, 56 (1%) were diagnosed with sarcomatoid carcinomas. Twenty received neoadjuvant and/or adjuvant chemotherapy. Overall radiographic response rate (minor + major) to neoadjuvant chemotherapy was 73% (95% confidence interval 48-90%) in the 15 evaluable patients. The median DFP of patients who received chemotherapy was 34 months versus 12 months in those who did not (p = 0.37). Subset analysis did not reveal a benefit to perioperative chemotherapy in patients with stage Ib-IIa, whereas a benefit was seen in patients with IIb-IIIa disease (p = 0.02). CONCLUSIONS:: Although sarcomatoid carcinomas are felt to be chemo-refractory, our results demonstrate radiographic responses to neoadjuvant chemotherapy and an improvement in DFP in patients with stage IIb-IIIa disease. The use of pathological stage in this analysis may underestimate this benefit. Perioperative chemotherapy should be considered in these patients. Copyright © 2012 by the International Association for the Study of Lung Cancer. |
| Keywords: | adult; cancer chemotherapy; cancer survival; controlled study; treatment outcome; aged; aged, 80 and over; middle aged; cancer surgery; survival rate; major clinical study; review; carcinoma, squamous cell; bevacizumab; cisplatin; erlotinib; cancer patient; disease free survival; chemotherapy, adjuvant; neoadjuvant therapy; follow-up studies; neoplasm staging; adenocarcinoma; antineoplastic combined chemotherapy protocols; carcinoma, non-small-cell lung; lung neoplasms; medical record review; docetaxel; adjuvant chemotherapy; sarcomatoid carcinoma; lung carcinoma; perioperative period; neoadjuvant chemotherapy; perioperative chemotherapy; pemetrexed; non-small-cell lung cancer; hemoptysis; carcinosarcoma; carcinoma, large cell; adjuvant chemoradiotherapy; pulmonary sarcomatoid carcinoma; lung sarcomatoid carcinoma |
| Journal Title: | Journal of Thoracic Oncology |
| Volume: | 7 |
| Issue: | 9 |
| ISSN: | 1556-0864 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2012-09-01 |
| Start Page: | 1400 |
| End Page: | 1405 |
| Language: | English |
| DOI: | 10.1097/JTO.0b013e3182614856 |
| PROVIDER: | scopus |
| PUBMED: | 22895138 |
| PMCID: | PMC3632635 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 October 2012" - "Source: Scopus" |
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