OBJECTIVE: To evaluate outcome and prognostic factors of patients with primary pulmonary sarcoma (PPS) who underwent curative-intent surgery within multimodality treatment. METHODS: An international, multicenter, retrospective study including patients with PPS was performed through a network of sarcoma experts. Data on demographics, staging, treatment, and outcomes were retrieved. Overall survival was calculated from the date of diagnosis. Prognostic factors were assessed using uni- and multivariate analysis. RESULTS: Eighteen centers from 9 countries contributed, for a total of 173 patients. One hundred fifteen patients (66%) underwent curative-intent surgery within multimodality treatment. There were 58 male patients (50%). Twenty-two patients (20%) had metastases, mainly to lung (n = 7, 30%) and pleura (n = 9, 39%). Thirty-three patients (30%) underwent preoperative chemotherapy. Extent of lung resection was sublobar (n = 11, 10%), lobar (n = 58, 54%), or bilobar/pneumonectomy (n = 39, 36%). Median tumor size was 85 mm. Sixty-nine patients had grade 3 tumors (71%). Resection was complete in 85 patients (75%). Lymphadenectomy was performed in 70 patients (63%), with nodal involvement in 10 (14%). Thirty-seven (37%) patients received adjuvant chemotherapy, and 27 (27%) patients received adjuvant radiotherapy. Overall survival was 49% and 31% at 5 and 10 years, respectively. Median follow-up was 33 months. Male gender (P = .003), age older than 60 years (P = .021), presence of metastasis (P = . 002), tumor size >40 mm (P = . 046), and incomplete resections (P = . 008) were independent prognostic factors for poor survival. CONCLUSIONS: In patients with curative-intent multimodal treatment for PPS, an encouraging 5-year survival rate of 49% can be achieved in expert centers. Independent prognostic factors may aid in selecting patients for curative treatment.

Département d'Oncologie Médicale Centre Léon Bérard Lyon France

Department of Clinical Oncology Cliniques Universitaires Saint Luc Institut Roi Albert 2 Université Catholique de Louvain Brussels Belgium

Department of Comprehensive Cancer Care Masaryk Memorial Cancer Institute and Faculty of Medicine Masaryk University Brno Czech Republic

Department of General Medical Oncology University Hospitals Leuven Leuven Cancer Institute Leuven Belgium

Department of Medical Oncology and Sarcoma Center West German Cancer Center University Hospital Essen Essen Germany

Department of Medical Oncology Centre Oscar Lambret University of Lille Lille France

Department of Medical Oncology Department of Medicine Hospital Clínico San Carlos School of Medicine Instituto de Investigación Sanitaria Madrid Spain

Department of Medicine and Surgery Università Campus Bio Medico di Roma Roma Italy

Department of Oncology Clinical Oncology Unit University Hospital Careggi Firenze Italy

Department of Soft Tissue Bone Sarcoma and Melanoma Maria Sklodowska Curie National Research Institute of Oncology Warsaw Poland

Department of Thoracic Surgery Francisco Gentil Portuguese Institute of Oncology Lisboa Portugal

Department of Thoracic Surgery Louis Pradel Hospital Hospices Civils de Lyon Lung and Heart Lung Transplantation Lyon France

Department of Thoracic Surgery Medical University of Vienna Vienna Austria

Department of Thoracic Surgery University of Witten Herdecke Kliniken der Stadt Koeln Lung Clinic Cologne Germany

Discovery Life Sciences Biomarker GmbH und Pathologie Nordhessen Kassel Deutschland

Division of Thoracic Surgery and Hyperbaric Surgery Department of Surgery Medical University of Graz Graz Austria

Institut du Thorax Curie Montsouris Institut Curie Paris France

Institute for Research in Operative Medicine University Witten Herdecke Cologne Germany

Laboratory of Experimental Oncology KU Leuven Leuven Cancer Institute Leuven Belgium

Medical Oncology 1 Unit Istituto Oncologico Veneto IOV IRCCS Padova Italy

Medical Oncology Department and INSERM U1339 CNRS UMR 3666 Institut Curie Paris France

Oncology Unit IRCCS AOUBO Bologna Italy

Operative Research Unit of Medical Oncology Fondazione Policlinico Universitario Campus Bio Medico Roma Italy

SSD Mesotelioma melanoma e tumori rari Azienda Ospedaliera Universitaria SS Antonio e Biagio e Cesare Arrigo Alessandria Italy

Thoracic Surgery Unit IRCCS National Cancer Institute Regina Elena Rome Italy

Unità Operativa Tumori Rari e Melanoma 1 R C C S Istituto Tumori Giovanni Paolo 2 Bari Italy

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