Bronchioloalveolar carcinoma of the lung: Recurrences and survival in patients with stage I disease

Objectives: The aim of our study was to retrospectively compare the patient characteristics, the frequency and pattern of recurrent disease, and survi val in patients with stage I bronchioloalveolar carcinoma and adenocarcinom a of the lung. Methods: Patients with stage I bronchioloalveolar carcinoma or adenocarcino ma other than bronchioloalveolar carcinoma resected between 1984 and 1992 w ith adequate clinical follow-up were studied. The clinical characteristics of the patients, extent of initial surgical resection, sites of recurrent d isease, and overall survival were examined and compared between the 2 group s. The median follow-up for patients with bronchioloalveolar carcinoma and adenocarcinoma was 6.2 years and 5.9 years, respectively. Results: A total of 138 patients were identified. Thirty-three patients had bronchioloalveolar carcinoma and 105 patients had adenocarcinoma. Eleven ( 33%) of the patients with bronchioloalveolar carcinoma had never smoked cig arettes versus 9 (9%) of the patients with adenocarcinoma (P = .0036). Ther e were no significant differences between patients with bronchioloalveolar carcinoma and adenocarcinoma in sex distribution and overall recurrence rat e. Of the 12 patients with recurrent bronchioloalveolar carcinoma, 1 patien t (8%) had extrathoracic disease develop at the site of first recurrence co mpared with 49% of patients with recurrent adenocarcinoma (P < .001). The 5 -year survival in patients with bronchioloalveolar carcinoma and in those w ith adenocarcinoma was 83% and 63%, respectively (P = .04). Conclusions: Stage I bronchioloalveolar carcinoma is more likely to occur i n nonsmokers. Survival is longer in patients with bronchioloalveolar carcin oma. Further research is warranted to define the etiology, clinical course, and molecular abnormalities in patients with bronchioloalveolar carcinoma to generate more effective therapeutic approaches.