The Role of Surgery on the Treatment of Primary Pulmonary Sarcomas and Pulmonary Sarcomatoid Carcinoma.

Abstract

We aimed to investigate clinicopathological features and survival outcomes of patients diagnosed with primary pulmonary sarcoma (PPS) or pulmonary sarcomatoid carcinoma (PSC). Both PPS (N = 156) and PSC (N = 175) patients diagnosed in our hospital between 2015.9-2024.9 were included and retrospectively analyzed. Among them, 77 PPS patients (49.4%) and 82 PSC patients (46.9%) underwent radical resection, while patients with unresectable diseases received systemic treatment and radiotherapy. Clinical and pathological characteristics were summarized and compared. Survival analysis and multivariable cox regression were also performed using overall survival (OS) data. The 5-year survival rates among surgically treated patients were 42.3% for PPS and 32.2% for PSC. Among patients with PPS, the median survival was 3.44 years for those who underwent surgery and 0.52 years for those who did not. In PSC, the median survival was 2.16 years with surgery and 0.96 years without surgery. Perioperative systemic therapy-primarily chemoradiotherapy-did not confer significant survival benefits. In the unresectable population, targeted therapy and immunotherapy may offer prognostic improvement for both PPS and PSC. Surgical resection potentially provides PPS and PSC patients with the opportunity of long-term survival. For unresectable diseases, immunotherapy as well as targeted therapy may contribute to improved survival outcome.