Clinical characteristics and prognosis of fifteen cases of spindle cell carcinoma of the lung

doi:10.3877/cma.j.issn.1674-0785.2018.02.006

Abstract

Abstract:

Objective

To analyze the clinical characteristics and prognosis of spindle cell carcinoma of the lung (SpCC).

Methods

A total of 15 patients were hospitalized at our hospital between 2012 and 2014 for treatment of SpCC. We retrospectively analyzed their clinical characteristics and prognosis.

Results

Fifteen of 6058 patients with primary lung cancer were diagnosed with SpCC. Of them, twelve were male and three were female, with a median age of 58.0 years. Nine were current- or ex-smokers with substantial smoking histories. Computed tomography (CT) findings revealed that the tumors were quite large (mean diameter, 53.6±20.3 mm), with three cases having invasion of adjacent structures and 12 tumors located peripherally. Positron emission tomography-CT (PET-CT) was performed in seven patients, and the standardized uptake value (SUV) tended to be high (12.8±4.3), which was significantly higher than other NSCLC cases at the same stage (P=0.003). The median survival was 12.1 months. In 11 patients who underwent surgical treatment, recurrence and metastases frequently occurred. Patients who had undergone surgical resection survived longer than those who did not (P=0.01). Postoperative chemotherapy did not significantly prolong the survival time (P=0.03).

Conclusions

SpCC of the lung is extremely rare and has strong malignant potential with frequent recurrence and distant metastases. Response to chemotherapy is generally poor. Surgical treatment at early stage might result in better prognosis.

Key words: Spindle cell carcinoma of the lung, Clinical characteristics, Therapy, Prognosis

Zhipeng Shao, Song Zhao, Renfeng Zhang, Chuangye Wei, Yong Long. Clinical characteristics and prognosis of fifteen cases of spindle cell carcinoma of the lung[J]. Chinese Journal of Clinicians(Electronic Edition), 2018, 12(02): 90-94.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhlcyszz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0785.2018.02.006

https://zhlcyszz.cma-cmc.com.cn/EN/Y2018/V12/I02/90

Figures/Tables 4

References 18

1	Maggiore C，Mule A，Fadda G，et al． Histological classification of lung cancer [J]. Rays, 2004, 29(4): 353-355.
2	Rossi G, Cavazza A, Sturm N, et al. Pulmonary carcinomas with pleomorphic, sarcomatoid, or sarcomatous elements: a clinicopathologic and immunohistochemical study of 75 cases [J]. Am J Surg Pathol, 2003, 27(3): 311-324.
3	Terada T. Spindle cell carcinoma of the lung: Frequency, clinical features, and immunohistochemical studies of three cases [J]. Respiratory Medicine CME, 2010, 3(4): 241-245．
4	Travis WD, Brambilla E, Nicholson AG, et al. The 2015 World Health Organization classification of lung tumors: impact of genetic, clinical and radiologic advances since the 2004 classification [J]. J Thorac Oncol, 2015,10(9):1243-1260.
5	Travis WD. Classification of lung cancer [J]. Semin in Roentgenol, 2011, 46(3):178-186.
6	Yendamuri S, Caty L, Pine M, et al. Outcomes of sarcomatoid carcinoma of the lung: a surveillance, epidemiology, and end results database analysis [J]. Surgery, 2012, 152(3): 397-402.
7	Kontic M, Stojsic J, Stevic R, et al. Could spindle cell lung carcinoma be considered and treated as sarcoma, according to its clinical course, morphology, immunophenotype and genetic finding? [J]. Pathol Oncol Res, 2013, 19(1): 129-133.
8	Kim TS, Han J, Lee KS, et al. CT findings of surgically resected pleomorphic carcinoma of the lung in 30 patients [J]. AJR Am J Roentgenol, 2005, 185(1): 120-125.
9	Kim TH, Kim SJ, Ryu YH, et al. Pleomorphic carcinoma of lung: comparison of CT features and pathologic findings [J]. Radiology, 2004, 232(2): 554-559.
10	Venissac N, Pop D, Lassalle S, et al. Sarcomatoid lung cancer (spindle/giant cells): an aggressive disease? [J]. J thorac cardiovasc surg, 2007, 134(3): 619-623.
11	Sugawara E, Kumagai J, Sanai A, et al. A Patient with pulmonary spindle cell carcinoma [J]. Haigan, 2010, 50(2): 178-185.
12	Tonai K, Kitasato Y, Kawakami T, et al. Autopsy case of rapidly progressive pulmonary spindle cell carcinoma with multiple metastases to the brain and pancreas [J]. Nihon Kokyuki Gakkai Zasshi, 2009, 47(9): 828-832.
13	Tournoy KG, Maddens S, Gosselin R, et al. Integrated FDG-PET/CT does not make invasive staging of the intrathoracic lymph nodes in non-small cell lung cancer redundant: a prospective study [J]. Thorax, 2007, 62(8): 696-701.
14	Hamanaka K, Toishi M, Nishimura H. A case of rapidly progressing pulmonary spindle cell carcinoma [J]. Japanese Journal of Lung Cancer, 2005, 45(4): 363-366.
15	Yendamuri S, Caty L, Pine M, et al. Outcomes of sarcomatoid carcinoma of the lung: a Surveillance, Epidemiology, and End Results Database analysis [J]. Surgery, 2012, 152(3): 397-402.
16	Matsui K, Kitagawa M. Spindle cell carcinoma of the lung. A clinicopathologic study of three cases [J]. Cancer, 1991, 67(9): 2361-2367.
17	Sugano T, Mori M, Namba Y, et al. A case of sarcomatoid carcinoma of the lung successfully treated with carboplatin, paclitaxel and bevacizumab [J]. Nihon Kokyuki Gakkai zasshi, 2011, 49(4): 304-308.
18	Mainwaring MG, Poor C, Zander DS, et al. Complete remission of pulmonary spindle cell carcinoma after treatment with oral germanium sesquioxide [J]. Chest, 2000, 117(2): 591-593.

例号	性别	年龄	吸烟指数	症状	肿瘤最大直径（mm）	病变部位	PET-CT标准摄取值（SUV）	临床分期	病理分期	化疗	随访时间（月）
1	男	63	60	C＋E	52	外周	10.6	T₃N₀M₀ ⅡB	T₃N₀M₀ ⅡB	否	13.3
2	男	51	0	C＋CP	65	外周	?	T₃N₁M₀ ⅢA	T₃N₁M₀ ⅢA	是	5.0
3	男	57	30	C＋F	41	外周	7.9	T₃N₁M₀ ⅢA	T₃N₁M₀ ⅢA	是	10.6
4	男	46	0	C＋CD＋E	38	外周	15.6	T_2aN₀M₀ ⅠB	T_2aN₁M₀ ⅡB	否	11.5
5	男	59	50	CD＋CP	71	外周	?	T₄N₀M₀ ⅢA	T₄N₁M₀ ⅢA	是	15.6
6	男	59	0	H	34	外周	?	T_2aN₀M₀ ⅠB	T_2aN₀M₀ ⅠB	否	25.4
7	男	47	20	CP	29	中央	?	T_1cN₀M₀ ⅠA	T_1CN₀M₀ ⅠA	否	21.9
8	男	61	60	CP＋H＋F	60	外周	?	T₃N₀M₀ ⅡB	T₃N₁M₀ ⅢA	是	2.1
9	男	62	0	--	26	外周	?	T_1bN₀M₀ ⅠA	T_1bN₀M₀ ⅠA	否	14.3
10	女	57	20	C＋E＋CD	61	外周	11.7	T₃N₀M₀ ⅡB	T₃N₁M₀ ⅢA	否	8.2
11	女	51	0	C＋E	41	中央	20.0	T_2bN₀M₀ ⅡA	T_2bN₀M₀ ⅡA	否	18.8
12	男	81	120	C＋E＋H＋F	56	外周	8.9	T₃N₀M₀ ⅡB	?	是	10.1
13	女	67	0	CD	51	外周	?	T₃N₁M₀ ⅢA	?	是	12.1
14	男	53	20	CD＋CP	95	外周	?	T₄N₂M₀ ⅢB	?	是	3.7
15	男	79	50	C＋CD	83	中央	15.2	T₄N₁M_1b ⅣA	?	是	1.8

例号	性别	年龄	吸烟指数	症状	肿瘤最大直径（mm）	病变部位	PET-CT标准摄取值（SUV）	临床分期	病理分期	化疗	随访时间（月）
1	男	63	60	C＋E	52	外周	10.6	T₃N₀M₀ ⅡB	T₃N₀M₀ ⅡB	否	13.3
2	男	51	0	C＋CP	65	外周	?	T₃N₁M₀ ⅢA	T₃N₁M₀ ⅢA	是	5.0
3	男	57	30	C＋F	41	外周	7.9	T₃N₁M₀ ⅢA	T₃N₁M₀ ⅢA	是	10.6
4	男	46	0	C＋CD＋E	38	外周	15.6	T_2aN₀M₀ ⅠB	T_2aN₁M₀ ⅡB	否	11.5
5	男	59	50	CD＋CP	71	外周	?	T₄N₀M₀ ⅢA	T₄N₁M₀ ⅢA	是	15.6
6	男	59	0	H	34	外周	?	T_2aN₀M₀ ⅠB	T_2aN₀M₀ ⅠB	否	25.4
7	男	47	20	CP	29	中央	?	T_1cN₀M₀ ⅠA	T_1CN₀M₀ ⅠA	否	21.9
8	男	61	60	CP＋H＋F	60	外周	?	T₃N₀M₀ ⅡB	T₃N₁M₀ ⅢA	是	2.1
9	男	62	0	--	26	外周	?	T_1bN₀M₀ ⅠA	T_1bN₀M₀ ⅠA	否	14.3
10	女	57	20	C＋E＋CD	61	外周	11.7	T₃N₀M₀ ⅡB	T₃N₁M₀ ⅢA	否	8.2
11	女	51	0	C＋E	41	中央	20.0	T_2bN₀M₀ ⅡA	T_2bN₀M₀ ⅡA	否	18.8
12	男	81	120	C＋E＋H＋F	56	外周	8.9	T₃N₀M₀ ⅡB	?	是	10.1
13	女	67	0	CD	51	外周	?	T₃N₁M₀ ⅢA	?	是	12.1
14	男	53	20	CD＋CP	95	外周	?	T₄N₂M₀ ⅢB	?	是	3.7
15	男	79	50	C＋CD	83	中央	15.2	T₄N₁M_1b ⅣA	?	是	1.8

[1]	The Joint Surgery Branch of the Chinese Orthopedic Association, Guangdong’s Medical Association of Osteoporosis And Bone Mineral Research, Foshan Shunde 3rd Peoele’s Hospital. Clinical intervention guideline for using of anti-osteoporosis drugs in postoperative fragile hip fractures in China (2023 Edition) [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(06): 751-764.
[2]	Siping Zhang, Wei Liu, Pengcheng Ma. Therapeutic effects of lower extremity mild varus alignment after total knee arthroplasty [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(06): 808-817.
[3]	Wei Zhang. Dentoalveolar surgery: The pioneer of comfortable treatment [J]. Chinese Journal of Stomatological Research(Electronic Edition), 2023, 17(06): 386-388.
[4]	Yuezhou Li, Kongxi Zhang, Xiaohong Li, Zhonghua Shang. Prognostic significance of PUM in gastric carcinoma based on bioinformatics analysis [J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(06): 426-432.
[5]	Jun Zhang, Zai Luo, Mingyu Duan, Zhengjun Qiu, Chen Huang. Research progress of prognostic prediction models for gastric cancer [J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(06): 456-461.
[6]	Dechen Wang, Kang Yang, Zijie Yang, Mingbin Gui, Lianping Qu, Xiaofeng Zhang, Feng Gao. Progress of microsatellite stability state and PD-1/PD-L1/IDO in colorectal carcinoma [J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(06): 462-465.
[7]	Yanhui Zhang, Jiao Zhang, Zhixian Zhu. Effect of indwelling anal tube on anastomotic leakage after laparoscopic total mesangectomy after neoadjuvant chemoradiotherapy in patients with middle and low rectal cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 25-28.
[8]	Qian Yang, Cuifang Li, Wanqiu Zhang. Analysis of short-term and long-term prognosis and influencing factors of primary liver cancer with spontaneous ruptured hemorrhage after emergency TACE surgery [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 33-36.
[9]	Yansong Li, Huimin Feng, Mingchao Liu, Zepeng Liu, Qiuxia Jiang. Expression and clinical significance of STIP1 in triple negative breast cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 52-56.
[10]	Zhibo Gu, lin Hao, Ming Lu, Jiangang Chen. Photodynamic nanocarriers combined with siP3H4 for precise targeting therapy in the treatment of bladder cancer: a pilot study [J]. Chinese Journal of Endourology(Electronic Edition), 2023, 17(06): 633-641.
[11]	Yongsheng Li, Jiahe Sun, Shuwei Guo, Yikang Lu, Hongzhou Liu. Short-term postoperative complications and their influencing factors in elderly patients with colorectal cancer [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(9): 962-967.
[12]	Jun Wang, Kunpeng Liu, Lan Yao, Hua Zhang, Yue Wei, Libin Suo, Jun Chen, chengli Miao, Chenghua Luo. Retrospective analysis of anesthesia management of massive transfusion patients undergoing retroperitoneal tumor resection [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(08): 844-849.
[13]	Ruixue Yue, Lingxin Kong, Xin Hao, Jinqiang Yang, Meng Han, Guozhong Cui, Jianjun Wang, Zhisheng Zhang, Fanting Kong, Wei Zhang, Wenbo He, Xianqiao Li, Xinping Zhou, Donghong Xu, Chongzhu Hu. HER2 protein expression levels predict efficacy of neoadjuvant therapy in breast cancer: A real-world study [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(07): 765-770.
[14]	Libin Suo, Kunpeng Liu, Lan Yao, Hua Zhang, Yue Wei, Jun Wang, Jun Chen, Chengli Miao, Chenghua Luo. Key points of anesthesia management and prognostic factors in patients undergoing primary retroperitoneal paraganglioma resection [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(07): 771-776.
[15]	Meisha Fu, Yuhua Zhou, Hui Li, Chunyan Xue. Effect of lymphocyte immunotherapy on T lymphocyte subset distribution and PD1/PD-L1 expression in patients with recurrent miscarriage [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(06): 726-730.

Please choose a citation manager

Content to export