P2.04-029 Primary Pulmonary Sarcoma: Risks and Optimal Surgical Treatment Options: Topic: Esophageal Cancer and Other Malignancies

Abstract

Primary pulmonary sarcoma (PPS) is a rare tumor among malignant lung neoplasms. We aimed to clarify the clinical characteristics and therapeutic outcomes of patients who underwent surgical resection for PPS and to discuss beneficial treatment and surgical options. We retrospectively reviewed the records of those who underwent surgical resection for primary pulmonary sarcoma in our institution between 1995 and 2014. Cases only with biopsy were excluded. Twenty four patients were analyzed. Eighteen were male. Their ages ranged from 18 to 83 years (mean 57). Surgical procedures were pneumonectomy in 10, lobectomy in 11 and wedge resection in 3. Complete resection was achieved in 14. Pathological stage based on the 7th lung cancer TNM classification were stage I in 4, II in 12, III in 2, and IV in 5. Four patients had metastasis in lymph nodes. The pathological grades were G1 in 4, G2 in 5 and G3 in 15. Five patients had postoperative complications. Tumor recurrence was observed in 5. During the observation 12 patients died. 5-year overall survival was 50.1%. Adverse prognostic factors for overall survival were detected as (p=0.001), incomplete resection (p=0.014), advanced pathological stage (p=0.001), higher pathological grade (p=0.028), and tumor size more than 7cm (p=0.044). Our series of primary pulmonary sarcoma revealed that pneumonectomy, incomplete resection, advanced pathological stage, higher pathological grade, and tumor size were unfavorable factors for long survival. Although complete resection is essential for primary pulmonary sarcoma due to its poor prognosis, it is recommended to avoid pneumonectomy, if possible, and to consider conservative surgical approaches including sleeve lobectomy.