Multimodality treatment including surgery for primary pulmonary sarcoma: Size does matter

• Published in: Journal of surgical oncology 2020-09, Vol.122 (3), p.506-514
• Main Authors: Collaud, Stéphane, Stork, Theresa, Schildhaus, Hans‐Ulrich, Pöttgen, Christoph, Plönes, Till, Valdivia, Daniel, Zaatar, Mohamed, Dirksen, Uta, Bauer, Sebastian, Aigner, Clemens
• Format: Article
• Language: English
• Subjects: induction; Lung cancer; lung sarcoma; Medical prognosis; multimodality treatment; primary pulmonary sarcoma; Sarcoma; surgery
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.25979

Background and Objectives Primary pulmonary sarcoma (PPS) accounts for less than 1.1% of all pulmonary tumors. Few outcome data are reported. We evaluated outcome and prognostic factors in our series. Methods We retrospectively reviewed all patients who underwent resection for PPS in our center from 2002 to 2018. Survival was calculated from the date of surgery until last follow‐up. Impact on survival of gender, type of lung resection, completeness of resection, grade, size, and TNM staging for lung cancer and soft tissue sarcoma (STS) was assessed. Results Thirteen patients were included. Eight (61.5%) patients received neoadjuvant treatment. Median tumor size at diagnosis was 11.5 cm (1‐30 cm). Type of lung resection was wedge (n = 2, 15%), lobectomy (n = 4, 31%), intrapericardial (n = 3, 23%), and extrapleural pneumonectomies (n = 4, 31%). In‐hospital mortality was 8%. Overall 5‐year survival was 60%. Median disease‐free survival was 17 months. Tumor size was a predictor for survival (P = .02) and recurrence (P = .05). Gender (P = .04) and type of lung resection (P = .04) were predictors of survival. T stage for STS of trunk and extremity, and TNM stage for lung cancer were predictors for recurrence (P = .03 and P = .04, respectively). Conclusion Surgical resection within a multimodality therapy concept in highly selected patients can offer good long‐term outcome.