肺原发恶性纤维组织细胞瘤20例

BACKGROUND AND OBJECTIVE: Primary malignant fibrous histiocytoma (MFH) of the lung is a type of rare sarcoma which showed a lack of detailed guidance about treatment and prognosis. The clinical features, treatment methods and prognosis of primary MFH of the lung were analyzed by this study to reveal some information of this disease. METHODS: The clinical data and survival state of 20 patients with primary pulmonary MFH treated in Cancer Institute and Hospital of Tianjin Medical University were collected. SPSS 16.0 software was used for statistical analysis. Kaplan-Meier method was applied to figure out whether gender, size, site and post-operative chemotherapy correlated to prognosis. COX regression was employed for multivariate prognostic analysis to find the unattached prognostic factors. Statistical significance was considered at P < 0.05. RESULTS: The clinical manifestations of primary pulmonary MFH mainly included cough, blood-stained sputum, chest pain, fever and chest distress. The one-year and two-year overall survival rates were 55.0% and 25.0%, respectively. Most cases died of local recurrence and distant metastasis. Multivariate COX regression analysis showed tumor size and location type were unattached prognostic factors. The patients with tumors smaller than 5 cm had a median survival of 27 months, while larger than 5 cm group's median survival was 8 months. The median survival of central tumor and the peripheral tumor were 6 months and 23 months respectively. CONCLUSION: Primary pulmonary MFH was a type of highly malignant sarcoma which had poor prognosis. The main effective treatment was surgery, yet the role of postoperative adjuvant chemotherapy in the whole course of treatment was undefined. Small mass size and peripheral type might be correlated to relatively better prognosis.