Clinical characteristics and prognosis of fifteen cases of spindle cell carcinoma of the lung

Objective To analyze the clinical characteristics and prognosis of spindle cell carcinoma of the lung (SpCC). Methods A total of 15 patients were hospitalized at our hospital between 2012 and 2014 for treatment of SpCC. We retrospectively analyzed their clinical characteristics and prognosis. Results Fifteen of 6058 patients with primary lung cancer were diagnosed with SpCC. Of them, twelve were male and three were female, with a median age of 58.0 years. Nine were current- or ex-smokers with substantial smoking histories. Computed tomography (CT) findings revealed that the tumors were quite large (mean diameter, 53.6±20.3 mm), with three cases having invasion of adjacent structures and 12 tumors located peripherally. Positron emission tomography-CT (PET-CT) was performed in seven patients, and the standardized uptake value (SUV) tended to be high (12.8±4.3), which was significantly higher than other NSCLC cases at the same stage (P=0.003). The median survival was 12.1 months. In 11 patients who underwent surgical treatment, recurrence and metastases frequently occurred. Patients who had undergone surgical resection survived longer than those who did not (P=0.01). Postoperative chemotherapy did not significantly prolong the survival time (P=0.03). Conclusions SpCC of the lung is extremely rare and has strong malignant potential with frequent recurrence and distant metastases. Response to chemotherapy is generally poor. Surgical treatment at early stage might result in better prognosis. Key words: Spindle cell carcinoma of the lung; Clinical characteristics; Therapy; Prognosis