ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Pulmonary carcinosarcomas: an evaluation of seven patients
Ülkü Yazıcı1, İrfan Taştepe1, Erkmen Gülhan1, Taner Ege1, Funda Demirağ1, Sadi Kaya1, Tamer Altınok2
1Department of Thoracic Surgery, Atatürk Thoracic and Cardiovascular Surgery Training and Research Hospital, Ankara
2Department of Thoracic Surgery, Medicine Faculty of Selçuk University, Konya
Background: Carcinosarcoma is a rare malignant mixed tumor of the lungs. We evaluated the diagnosis, treatment, and prognosis of this tumor along with the clinical and histological features.

Methods: The study included seven patients (all males; mean age 60 years; range 55 to 73 years) whose postoperative histopathologic diagnosis was pulmonary carcinosarcoma. The most common presenting symptom was cough (57%). Operations performed were upper lobectomy (n=2), pneumonectomy (n=2), lower lobectomy (n=1), sleeve upper lobectomy (n=1), and only exploration (n=1).

Results: Postoperative pathological examination showed positive margins in the patient treated with sleeve upper lobectomy. Histologically, epithelial characteristics of the tumors were consistent with squamous cell carcinoma (n=4), adenocarcinoma (n=2), and adenosquamous carcinoma (n=1). The sarcomatous component was of rhabdomyoblastic type in three, chondrosarcomatous type in two, and osteosarcomatous type in two tumors. Two patients had stage IB, two patients had IIB, two patients had IIIA, and one patient had IIIB tumors. Five patients had lymph node metastasis, involving the regional lymph nodes (N1) in two patients, and mediastinal lymph nodes (N2) in three patients. No mortality occurred in the early postoperative period. Two patients had prolonged air leak postoperatively. One patient died in the postoperative 14th month due to cranium metastasis and another patient died of myocardial infarction in the postoperative 21st month. The other patients were disease-free during a follow-up period of 6 to 103 months. The mean survival was estimated as 66 months, with one-year survival being 80% and five-year survival being 57%.

Conclusion: Complete surgical resection is the treatment of choice for early stage pulmonary carcinosarcoma. N2 disease is an unfavorable prognostic factor in patients with carcinosarcoma.

Keywords : Carcinosarcoma/pathology/surgery; lung neoplasms/ pathology/surgery; prognosis; survival rate
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