Bronchioloalveolar carcinoma: clinical, radiographic, and pathological findings - Surgical results

Background. Bronchioloalveolar carcinoma (BAC) remains one of the most cont roversial of lung cancer subtypes. Methods. From 1980 to 1938, 374 resected patients for NSCLC were followed u p in our department. Of the 147 cases histologically defined as adenocarcin oma, 34 were pure BAC. The records of these 34 patients were retrospectivel y reviewed in order to evaluate patient and tumor characteristics and to id entify which variables had a prognostic impact on survival and recurrence r ate. Results. Patient age, sex, smoking habits and symptoms were not differentia ting characteristics when related to radiographic presentation or to natura l history. Mucinous cell-type (23.6% of cases) was more frequent with non-s mokers, presence of a single nodule or mass and stage I, Favorable characte ristics were: a) the prevalence of stage I and NO cases (59% and 76.7% of c ases, respectively) with a mean survival time of 66 and 77 months, respecti vely; and b) the radiographic presentation of a solitary pulmonary nodule o r mass (76.4% of cases), that, independently of nodal involvement, showed a higher mean survival time (62 months), Independently significant adverse p rognostic factors were: stage II-TV, lymph node involvement, and patient ag e over sixty years. The radiographic presence of multiple or satellite nodu les was related to a significantly adverse prognosis (mean survival time: 1 8 months) by univariate analysis; this was not confirmed by multivariate an alysis. Conclusions. In our experience BAC was the NSCLC subtype more frequently as sociated with a good outcome after resection; surgery should not to be deni ed also in patients with multiple nodules, when under sixty years of age an d no lymph node involvement.