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1. Introduction
Pulmonary carcinosarcoma (PCS) is a rare tumour in humans [1, 2]. It was first defined by Kika et al. in 1908 as a poorly differentiated non-small-cell carcinoma containing a component with sarcoma or sarcoma-like features [3]. It accounts for 0.3 to 1% of all pulmonary cancers, and its clinical characteristics, preoperative diagnostic methods, and prognostic factors are still not completely understood [4]. Pulmonary carcinosarcomas occur predominantly in elderly men and middle-aged smokers [5]. This study evaluated the results of six cases who underwent surgery for PCS.
2. Material and Method
This was a retrospective study of six patients who underwent surgery for pulmonary tumours in our chest surgery clinic between January 1996 and January 2011 and who had a postoperative diagnosis of PCS. The patients were evaluated in terms of their age, gender, symptoms, diagnostic approaches, surgical methods, and followup findings.
All of the patients underwent routine laboratory studies, respiratory function tests, electrocardiography, chest X-ray, computed tomography (CT) of the thorax, brain CT or magnetic resonance imaging (MRI), abdominal ultrasound, and bronchoscopy. Three patients underwent positron emission tomography (PET)-CT. In the preoperative period, one patient without a cancer diagnosis was suspected of having lung cancer, and one patient had a diagnosis of carcinosarcoma, whereas the other four patients were diagnosed with non-small-cell lung cancer (NSCLC). The patient who had a preoperative diagnosis of carcinosarcoma had an endobronchial component and was diagnosed by bronchoscopy. The mediastinal lymph nodes were evaluated by mediastinoscopy in all but one patient. A standard posterolateral thoracotomy incision and intraoperative staging were done in all patients. Complete resection was done in all patients. All of the tumours were staged postoperatively according to the seventh international TNM staging system. The diagnosis was verified immunohistochemically.
All patients underwent clinical and radiological follow-up for a median of 7.5 (range 3–25) months. All patients were assessed quarterly for the first 2 years with a history, physical examination, and chest X-ray. Laboratory tests and advanced radiological methods were requested if there were any symptoms. Additionally, all patients or the families were asked by phone when the study was performed and asked about any signs of recurrence or complications.
The statistical analysis was done using SPSS ver. 11.5. Descriptive analyses and Kaplan-Meier survival analysis were used.