BRONCHIOLOALVEOLAR LUNG-CARCINOMA - RESULTS OF SURGICAL-TREATMENT ANDPROGNOSTIC FACTORS

Study design: To determine the long-term results after surgical treatm ent of bronchioloalveolar lung carcinoma (BALC) and to identify progno stic factors. Patients and methods: A retrospective study of 70 patien ts (49 men, 21 women), mean age 61+/-10 years, was carried out. Their carcinomas were classified into three clinicopathologic types: nodular or tumoral, pneumonic, and diffuse types All the diagnosed BALC cases were reviewed and were classified into histologic types: mucinous, no nmucinous (including fibrotic center), and mixed tumors. Univariate an d multivariate analyses were carried out. Results: The nodular or tumo ral type was identified in 42 patients, pneumonic in 21, and diffuse i n seven. Histologically, there were 36 mucinous, 25 nonmucinous, and n ine mixed tumors. Resection was complete in 61 instances (87%) and inc omplete in five. The 5-year survival rate was 34% in patients with cur ative resections. Five prognostic factors were identified by univariat e analysis, but in multivariate analysis, only three factors remained significant: the absence of symptoms, the TNM stage, and completeness of resection. Thirty-six patients with curative resection (59%) develo ped recurrences tin the lung in 26 patients; mediastinal lymph nodes, four; distant metastases, nine). The frequency of recurrence was signi ficantly greater in patients with pneumonic-type BALC than in nodular or tumoral types (p<0.01), and pulmonary recurrences were significantl y more frequent in pneumonic than in tumoral types (p<0.02). Conclusio ns: This study confirmed that the overall prognosis of BALC is not sig nificantly different from that of the other non-small cell lung; cance rs. We found that the lungs are the predominant site of recurrence in BALC, especially in the pneumonic types. The complete surgical resecti on of localized BALC offers the best chances of long-term survival.