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. 2018 Jul;10(7):4262-4273.
doi: 10.21037/jtd.2018.06.71.

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

Jiacheng Yin  1 , Yong Yang  2 , Ke Ma  1 , Xiaodong Yang  1 , Tao Lu  1 , Shuai Wang  1 , Yu Shi  1 , Cheng Zhan  1 , Yimeng Zhu  2 , Qun Wang  1
Affiliations

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

Jiacheng Yin et al. J Thorac Dis. 2018 Jul.

Abstract

Background: Pulmonary pleomorphic carcinoma (PPC) is a rare malignancy; unique clinicopathological characteristics and prognosis have not been described.

Methods: PPC patient information collected in the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2014 were extracted, evaluated, and compared with NSCLC patient data. Overall survival (OS) was evaluated by the Kaplan-Meier method. Univariate analysis (UVA) and multivariate analysis (MVA) by the Cox proportional hazards regression identified risk factors that predicted OS and the results were used to construct a nomogram to predict 1-, 3-, and 5-year OS in PPC patients.

Results: A total of 309 patients diagnosed with PPC were identified among the records of 320,510 NSCLC patients. The median age was 66 (IQR, 57-75) years, 59.2% were men, 79.3% were White, 63.9% had upper lobe tumors, 77.0% were poorly differentiated, and 38.0% were AJCC stage IV. Median OS was 9 (95% CI: 6.69-11.31) months and 5-year OS was 25.1% (95% CI: 23.6-26.6%). PPC patients had significantly larger and less differentiated tumors, a higher rate of radical surgical resection, less N+ disease, and fewer distant metastases (P<0.001) than NSCLC patients. UVA and MVA identified age, T stage, M stage, surgery, and chemotherapy as independent risk factors. The nomogram had a calibration index of 0.798.

Conclusions: PPC had distinct clinicopathological characteristics. Age, T stage, M stage, surgery and chemotherapy were independently associated with OS. The nomogram accurately predicted 1-, 3- and 5-year OS.

Keywords: Pulmonary pleomorphic carcinoma (PPC); clinicopathological characteristics; survival.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Kaplan-Meier estimate of overall survival of pulmonary pleomorphic carcinoma (PPC) and NSCLC patients.
Figure 2
Figure 2
Kaplan-Meier estimate of overall survival of patients by (A) age, (B) sex, (C) race.
Figure 3
Figure 3
Kaplan-Meier estimate of overall survival of patients by (A) tumor grade, (B) pleural invasion, and (C) AJCC stage.
Figure 4
Figure 4
Kaplan-Meier estimate of overall survival in patients treated by (A) surgery, (B) chemotherapy, or (C) radiation.
Figure 5
Figure 5
Nomogram to predict 1-, 3-, and 5-year overall survival of patients with pulmonary pleomorphic carcinoma (PPC).
Figure 6
Figure 6
Calibration plots of the nomogram prediction of (A) 1-year, (B) 3-year, and (C) 5-year overall survival of pulmonary pleomorphic carcinoma (PPC) patients. The red line represents equality of the observed and predicted probability.
See this image and copyright information in PMC

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