Background & objective: Lung pleomorphic (spindle/giant cell) carcinoma is a rare epithelial malignant tumor. This study was to investigate its clinicopathologic and prognostic characteristics.
Methods: Clinicopathologic records of 17 patients with lung pleomorphic (spindle/giant cell) carcinoma were reviewed and compared with those of the patients with other histopathologic types of lung cancer treated in the same period. All patients underwent surgical resection. Kaplan-Meier method was used for survival analysis. Cox proportional hazards model was used for prognostic analysis.
Results: The 17 patients consisted of 15 men and 2 women with median age of 58 (45-78)û 5 at stage I, 3 at stage II, and 9 at stage III by pathologic TNM staging. Of the 17 cases of lung pleomorphic (spindle/giant cell) carcinoma, 2 were lung exclusive spindle cell carcinoma, 5 were lung carcinoma with spindle cells (combined with one kind of epithelial components, such as squamous cell carcinoma in 3 cases, adenocarcinoma in 1 case, and large cell carcinoma in 1 case), 10 were lung carcinoma with giant cell carcinoma (combined with one kind of epithelial components in 5 cases, two kinds in another 5 cases). Four patients at stage I survived free of tumor for more than 5 years. The median survival time was significantly shorter in lung pleomorphic (spindle/giant cell) carcinoma patients than in lung squamous cell carcinoma patients (36 months vs. 61 months, P=0.027), and was also significantly longer in patients with carcinoma containing spindle cells (including spindle cell carcinoma) than in patients with carcinoma containing giant cells (64 months vs. 18 months,P=0.026). Lymph node metastasis and carcinoma containing giant cells were poor prognostic factors of lung pleomorphic (spindle/giant cell) carcinoma.
Conclusion: Lung carcinoma containing giant cells has multiple cells components, and has worse prognosis than lung carcinoma containing spindle cells and spindle cells carcinoma do.