Virtual Library
Start Your Search
Thomas Raptakis
Author of
-
+
EP1.09 - Pathology (ID 199)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Pathology
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
-
+
EP1.09-21 - Sarcomatoid Carcinoma of the Lung. Analysis of the Tumor Immune-Microenvironment and Survival of a Case Series (Now Available) (ID 2644)
08:00 - 18:00 | Author(s): Thomas Raptakis
- Abstract
Background
Sarcomatoid carcinoma is a poorly differentiated non-small-cell lung carcinoma that comprises 3 subtypes i)the pleomorphic including different components such as squamous cell carcinoma, adenocarcinoma, or undifferentiated non-small-cell carcinoma and at least 10% spindle and/or giant cells; ii)the spindle cell consisting only of spindle cells and iii)the giant cell. The study aimed to assess the presence of immune cells in tumoral environment and the survival of patients (pt) with these tumors
Method
Formalin-fixed paraffin-embedded tissues of pt treated with surgery for sarcomatoid carcinoma from 2009-2014 were retrieved and centrally revised and restaged. PAS diastase staining and immunohistochemistry with CK7, p63 and vimentin were performed to identify epithelial and mesenchymal components. The presence of tertiary lymphoid structures, plasma cells and necrosis were assessed. Clinical data were collected from patients’ files regarding adjuvant treatment (chemotherapy, radiotherapy) and survival. Institutional Review Board, Ethical Approval and patient’s signed informed consent were obtained.
Result
Ten pt of median age 74 (59-80) years, were treated with pneumonectomy (1 pt) upper (4pt) or lower (5pt) lobectomy for pleomorphic (8pt) or giant cell (2pt) sarcomatoid carcinoma. Squamous or adenocarcinoma components were each present in 4 pt. Visceral pleural involvement was present in 5pt and parietal in 1 pt. TNM staging and the composition of tumor microenvironment are shown in Table 1. Tumor spread through airspace was present in 3 pt and lymphovascular invasion in 5 pt. At the time of the analysis, only 2 pt were alive, the median time to recurrence was 11.5 months and the median survival was 1.8 years
Patient number
Staging WHO 8TH Edition
Plasma Cells
Tertiary Lymphoid Structures
Pattern of Necrosis
1
pT3N0 (IIB)
Absent
Focal Aggregates
Diffuse
2
pT4N1 (IIIA)
Small
Primary Follicles
Focal
3
pT2N1 (IIB)
Absent
Focal Aggregates
Diffuse
4
pT2N0 (IIA)
Small
Primary Follicles
Diffuse
5
pT2aN2 (IIIA)
Absent
Focal Aggregates
Focal
6
pT1cN0 (IA3)
Small
Focal Aggregates
Diffuse
7
pT2aN2 (IIIA)
Absent
Primary Follicles
Focal
8
pT1cN0 (IA3)
Absent
Focal Aggregates
Diffuse
9
pT1cN0 (IA3)
Intermediate
Primary Follicles
Diffuse
10
pT4N0 (IIIA)
Absent
Focal Aggregates
Diffuse
Sarcomatoid carcinoma represents a rare disease with an aggressive clinical course and a poor prognosis even in stage IA3 treated with combination therapies. The exact mechanisms whereby the formation of tertiary lymphoid structures occurs and their function remain elusive. Studying these changes could reveal new ways for modulating immune responses to prolong the survival of these pt.