Clinical features of patients with stage IIIB and IV bronchioloalveolar carcinoma of the lung

BACKGROUND. The incidence of bronchioloalveolar carcinoma of the lung (BAC) , a pathologically distinct type of nonsmall cell lung carcinoma (NSCLC), a ppears to be rising. In this study, the authors compared data on the clinic al presentation and clinical courses of patients with Stage IIIB and IV BAC with data on other types of NSCLC. METHODS. The authors collected clinical, radiographic, and pathology inform ation about 28 patients with Stage IIIB and IV BAC and 124 patients with ot her histologic types of NSCLC. RESULTS. Twelve of 28 BAC patients (43%) were women, compared with 40 of 12 4 control patients (32%). Nine (32%) of the patients with BAC had never smo ked cigarettes, versus 20 controls (16%) (P = 0.02). Eighteen patients (64% ) with BAC had bilateral multilobar or multicentric pulmonary involvement, compared with 13 controls (15%) (P < 0.001). Patients with advanced stage ( IIIB and TV) BAC had a median survival of 15 months from the time of diagno sis; for patients with other types of Stage IIIB and IV NSCLC, had a median survival of 10 months (P = 0.01). CONCLUSIONS. Patients with BAC of the lung have clinical, radiographic, and pathologic characteristics that distinguish them from patients with other types of NSCLC. A greater proportion of women and nonsmokers present with B AC than with other types of NSCLC. Patients with advanced stage BAC are mor e likely to have bilateral diffuse pulmonary involvement, are less likely t o develop brain metastases, and have longer survival than patients with oth er types of Stage IIIB and IV NSCLC. Further research is warranted to defin e etiology, molecular abnormalities, and more effective therapeutic interve ntions. Cancer 1999;86:1165-73. (C) 1999 American Cancer Society.