Pleomorphic Carcinoma of the Lung: Relationship Between CT Findings and Prognosis

Fujisaki, Akitaka; Aoki, Takatoshi; Kasai, Takahiko; Kinoshita, Shunsuke; Tomoda, Yoshitaka; Tanaka, Fumihiro; Yatera, Kazuhiro; Mukae, Hiroshi; Korogi, Yukunori

doi:10.2214/ajr.15.15542

Cited by 16 publications

(17 citation statements)

References 16 publications

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“…Fujisaki et al . reported that a massive central low‐attenuation area or cavity on CT, which both represent tumor necrosis, were predictors of poor survival in patients with PC of the lung 7. Conversely, in this study, the presence of a low‐attenuation area was not found to be prognostic; by contrast, air bronchogram was found to be a favorable prognostic factor.…”

Section: Discussioncontrasting

confidence: 72%

“…Pleomorphic carcinoma of the lung has a poor prognosis compared with other types of non‐small cell lung cancer . Previous studies examined the prognostic impacts of the clinicopathologic characteristics of PC of the lung, and showed that massive coagulative necrosis or a massive central low‐attenuation area of the tumor were negative prognostic factors . Coagulative necrosis observed in PC of the lung would suggest rapid proliferation of the tumor; in addition, it may facilitate systemic tumor dissemination through impairment of tumor vasculature .…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies examined the prognostic impacts of the clinicopathologic characteristics of PC of the lung, and showed that massive coagulative necrosis or a massive central low‐attenuation area of the tumor were negative prognostic factors . Coagulative necrosis observed in PC of the lung would suggest rapid proliferation of the tumor; in addition, it may facilitate systemic tumor dissemination through impairment of tumor vasculature . To date, information regarding the impact of CT features on survival of patients with PC of the lung is quite limited.…”

Section: Introductionmentioning

confidence: 99%

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Air bronchogram in pleomorphic carcinoma of the lung is associated with favorable prognosis

et al. 2018

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BackgroundPleomorphic carcinoma (PC) of the lung is a rare histological type of lung carcinoma. The association between computed tomography (CT) findings and histology with outcome remains unclear. We examined the relationships between CT features and histopathologic findings, and evaluated the impact of CT features and other clinicopathologic factors on survival.MethodsThirty‐five consecutive patients with PC of the lung who underwent surgery between October 2010 and December 2015 were enrolled in this study. The 35 tumors were classified with or without air bronchogram in the tumors, and with or without intratumoral ground glass opacity (GGO) on CT.ResultsAir bronchogram and GGO were detected in 12 (34.3%) and 5 (14.3%) tumors, respectively. Multivariate analysis revealed that air bronchogram was significantly associated with the presence of adenocarcinoma components with lepidic growth patterns (P = 0.005), and predominance of adenocarcinomas (P = 0.026). GGO was significantly associated with the presence of adenocarcinoma component with lepidic growth pattern (P = 0.010). Air bronchogram was an independent favorable prognostic factor for overall survival, whereas GGO did not have a significant effect on survival.ConclusionAir bronchogram observed in PCs of the lung is strongly related with histological components of the tumor and favorable outcome.

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Section: Discussioncontrasting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Air bronchogram in pleomorphic carcinoma of the lung is associated with favorable prognosis

et al. 2018

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“…Currently, we can determine that a tumor is GCLC by using CT, which shows a large and central low-attenuation area or cavity. This imaging is consistent with the tumor necrosis area found in pathological specimens [5]. There are data showing that the palliative chemotherapy response in advanced lung sarcomatoid carcinoma is poor [6].…”

Section: Introductionsupporting

confidence: 84%

Development and Validation a Nomogram and Prognosis of Chemotherapy for Evaluation in Giant-cell Lung Carcinoma With Metastases: A Propensity Score Matching Analysis

Yang¹,

Chen²,

Zhang³

et al. 2020

Preprint

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Background and Objectives: Whether chemotherapy couldimprove prognosis for giant-celllung carcinoma with metastases remains controversial. The present study aimed to determine the significanceof chemotherapy in patients with metastases giant-cell Lung carcinoma, and to develop a nomogram to predict its outcomes.Methods:Data of 566 patients from the Surveillance, Epidemiology, and End Results(SEER) database were analyzed; 346 matched patients were divided into a chemotherapy group and non-chemotherapy group, respectively, using the propensity scorematching method. Univariate and multivariate analyses were performed to determine theprognostic factors of giant-celllung carcinoma, and subgroup analysis was performed according tothe site of metastases. While a visual nomogram wasestablished to judge the prognosis.Results: With the median follow-up of 20.5 months, The 3-yearsurvival rates were 20.2% in the chemotherapy set and 16.7% in the non-chemotherapy set (P=0.006).Chemotherapy did improve the Giant-cell Lung Carcinoma survival rates in patients with metastases(HR = 0.490, 95% CI = 0.358–0.669, P<0.001). In subgroup analysis, radiotherapy did not improved the Giant-cell Lung Carcinoma survival rates in patients with metastases(HR = 0.951, 95% CI = 0.690-1.311, P = 0.758, Table 2). Chemotherapy improved the CSS in patients with lung metastases (HR = 0.090, 95% CI = 0.017-0.470, P =0.004).In addition, chemotherapy improved the CSS in patients with brain metastases (HR = 0.117, 95% CI = 0.014-0.955, P =0.045). Compared with bone metastasis, liver metastasis and metastasis of more than 2 sites, the effect of chemotherapy is not obvious.Furthermore, our nomogram could predict the probability of surviving to the median survival time of the population with a c-index of 0.768.Conclusion:The benefit of chemotherapy in giant-celllung carcinoma with metastases patients was obviously different, andthe recommendation of chemotherapy for this population should be individualized. chemotherapy shouldbe considered for patients with only lungmetastasis or brain metastasis, but chemotherapy could be avoided in those with other site metastases or multiple metastases.We developed the first competing risk nomogram to predict the risk of GCLC patients, which performed well in the evaluation and might be helpful for individualized screening.

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“…The benefits of surgery are less clear in patients with nodal metastasis. Raveglia et al (19) and Yuki et al (20) reported statistically significant differences in the OS of patients with pN0 and pN+ tumors, but Fujisaki et al found that the presence of lymph node metastasis at surgery did not predict OS or disease-free survival in another series of 44 patients (22). A 9-month benefit in median OS was seen in pN0 patients compared with pN1 patients who underwent surgery, but the difference was not statistically significant.…”

Section: Discussionmentioning

confidence: 96%

Clinicopathological characteristics and prognosis of pulmonary pleomorphic carcinoma: a population-based retrospective study using SEER data

Yin

Yang

et al. 2018

J. Thorac. Dis.

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Pleomorphic Carcinoma of the Lung: Relationship Between CT Findings and Prognosis

Abstract: A massive central low-attenuation area or cavity on CT was the only predictor of overall survival and disease-free survival in patients with lung PC.

Cited by 16 publications

References 16 publications

Air bronchogram in pleomorphic carcinoma of the lung is associated with favorable prognosis

Air bronchogram in pleomorphic carcinoma of the lung is associated with favorable prognosis

Development and Validation a Nomogram and Prognosis of Chemotherapy for Evaluation in Giant-cell Lung Carcinoma With Metastases: A Propensity Score Matching Analysis

Clinicopathological characteristics and prognosis of pulmonary pleomorphic carcinoma: a population-based retrospective study using SEER data

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