Berk CIMENOGLU, Attila OZDEMIR, Mesut BUZ, Fatma Tugba OZLU, Talha DOGRUYOL, Recep DEMIRHAN
Southern Clinics of Istanbul Eurasia - 2026;37(3):286-293
Objective: Pulmonary pleomorphic carcinoma (PPC) is one of the rarest subtypes of non-small cell lung cancer (NSCLC) and is associated with a poor prognosis. Since this tumor is known to be chemoresistant, anatomical resection is considered the primary treatment option, especially in the early stages. Due to its rarity, the number of studies on this subject in the literature is quite limited. In this study, we aimed to investigate the long-term postoperative outcomes of patients operated on for PPC and the factors affecting survival. Methods: Patients who underwent surgery for lung cancer were retrospectively reviewed. Those with a postoperative histopathological diagnosis of PPE were included. Demographic and clinicopathological characteristics were analyzed, and factors affecting overall survival (OS) and disease-free survival (DFS) were investigated. Results: A total of 25 patients who underwent surgery for PPC between 2016 and 2025 were included in the study. After excluding surgical mortality, the mean OS was calculated as 54.3+/-9.9 months, with a 5-year OS rate of 49.6%. Recurrence developed in 13 (52%) patients. The mean DFS was 43.1+/-9.9 months, and the 5-year DFS rate was 40.9%. Surgical incision analysis reveals the mean OS was 48.2+/-11.6 months and the 5-year OS rate was 43.8% in patients who underwent thoracotomy. These values were 77.6+/-12.9 months and 80% in patients who underwent VATS, respectively (p=0.048). A statistically significant relationship was found between stage and survival (p=0.042). Although not reaching statistical significance, the presence of spread-through air spaces (STAS), perineural invasion, and vascular invasion was associated with poorer prognosis. Conclusions: In our study, the prognostic factors that had a statistically significant effect on survival in PPC were the use of minimally invasive surgery and the stage of the disease. Invasion-related parameters such as STAS, perineural invasion, and vascular invasion were also found to negatively affect survival, although they did not reach statistical significance.
