Comparative analysis of clinical features and prognostic factors in resected bronchioloalveolar carcinoma and adenocarcinoma of the lung.

Abstract

BACKGROUND:

Over the past few years, clinical, radiological and pathological classification of lung adenocarcinoma and its subtypes, particularly bronchioloalveolar carcinoma (BAC), has radically changed.

PATIENTS AND METHODS:

Out of a series of 384 non-small cell lung cancer (NSCLC) patients, submitted to surgical resection and followed-up in our Department from 1981 to 1999, the data of 151 adenocarcinomas (35 BAC and 116 non-BAC) were reviewed and analyzed for prognosis.

RESULTS:

BAC and non-BAC series were similar in clinical and radiographic findings, type of resection and stage. Stage I was a dominant favorable prognostic factor (10-year survival: 58% of BAC, 41.2% of non-BAC), albeit associated with a significant risk of second primary metachronous lung tumor (10-year risk: 25% of BAC, 32% of non-BAC). Other independent prognostic factors were: absence of lymph node involvement for BAC and stage III-IV for non-BAC. In term of prognosis, advantages of BAC over non-BAC were fewer cases with lymph node involvement, increased presence of "well-differentiated" cells (p = 0.016) and lower incidence of a second primary metachronous tumor. Moreover BAC patients with a single nodule or mass also had a higher survival expectancy (mean survival: 77 months versus 56 for non-BAC). An unfavorable feature was the higher incidence of diffuse or multicentric radiological forms (p = 0.012). For both groups the presence of multiple or satellite nodules remain a diagnostic and surgical challenge: in BAC cases the evaluation of clonality is recommended.

• Authors: Patrizia Volpino, Antonino Cavallaro, Roberto Cangemi, Flavia Chiarotti, Alessandro De Cesare, Enrico Fiori, Marco Bononi, Rossana Vigliarolo, Vincenzo Cangemi
• Journal: Anticancer research (Anticancer Res) 2003 Nov-Dec Vol. 23 Issue 6D Pg. 4959-65 ISSN: 0250-7005 [Print] Greece
• PMID: 14981952 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Organophosphorus Compounds
• Organotechnetium Compounds
• technetium tc-99m tetrofosmin

Topics

• Adenocarcinoma (diagnostic imaging, pathology, surgery)
• Adenocarcinoma, Bronchiolo-Alveolar (diagnostic imaging, pathology, surgery)
• Aged
• Female
• Follow-Up Studies
• Humans
• Lung Neoplasms (diagnostic imaging, pathology, surgery)
• Male
• Middle Aged
• Multivariate Analysis
• Neoplasm Recurrence, Local (pathology)
• Neoplasm Staging
• Organophosphorus Compounds
• Organotechnetium Compounds
• Prognosis
• Retrospective Studies
• Survival Rate
• Tomography, Emission-Computed, Single-Photon