Bronchoalveolar carcinoma: Clinical, radiologic, and pathologic factors and survival

Background: The principal feature of bronchoalveolar carcinoma is that it s preads along airways or aerogenously with multifocality, but many issues ar e unresolved. Methods: We studied 119 patients with pathologically confirme d bronchoalveolar carcinoma. Symptoms, smoking status, radiologic findings, the size of tumor, operative procedures, and complications were reviewed, We studied the pathologic features: presence or absence of aerogenous sprea d, patterns of growth, cell type, nuclear grade, mitosis, rate of bronchoal veolar carcinoma in adenocarcinoma, and lymphocyte infiltration. The correl ation among clinical, radiologic, and pathologic findings was examined, and the factors affecting survival were analyzed, Results: Symptomatic patient s had more infiltrative radiographic features, and asymptomatic patients te nded to have more mass-like features (P < .0001), Tumors with radiographica lly infiltrating lesions tended to have mucinous histologic features (P = . 006). Tumors with mass lesions by radiograph tended to have nonmucinous and sclerosing histologic features (P = .003). Aerogenous spread was seen in 9 4% of specimens. The presence of a variety of cell types suggested multiple clonal origin. The overall survival in those patients undergoing resection was 69.1% at 5 years and 56.5% at 10 years. The significant factors affect ing survival were radiologic presence of a mass or infiltrate, pathologic f indings of the presence of sclerosis, association with a scar, the rate of bronchoalveolar carcinoma in adenocarcinoma, lymphocyte infiltration grade, nodal involvement, and status of complete resection, Mitosis or nuclear gr ade of tumor cells did not correlate with survival. Conclusions: Bronchoalv eolar carcinoma showed good overall survival with appropriate surgical proc edures; Certain radiologic or pathologic findings correlated with survival. These findings may enhance the ability to predict long-term survival.