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A Journal on Cardiac, Vascular and Thoracic Surgery

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The Journal of Cardiovascular Surgery 2001 April;42(2):261-7

language: English

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

Volpino P., D’Andrea N., Cangemi R. *, Mingazzini P. **, Cangemi B., Cangemi V.

From ­the 1st Department of Surgery
*1st Department of Medicine
**Department of Experimental Medicine ­and Pathology
University of Rome “La Sapienza”, Rome, Italy


Background. Bronchioloalveolar car­ci­no­ma (­BAC) ­remains ­one of ­the ­most con­tro­ver­sial of ­lung can­cer sub­types.
Methods. From 1980 to 1998, 374 resect­ed ­patients ­for ­NSCLC ­were fol­lowed up in ­our depart­ment. Of ­the 147 cas­es his­to­log­i­cal­ly ­defined as aden­o­car­cin­o­ma, 34 ­were ­pure ­BAC. The ­records of ­these 34 ­patients ­were ret­ro­spec­tive­ly ­reviewed in ­order to eval­u­ate ­patient ­and ­tumor char­ac­ter­is­tics ­and to iden­ti­fy ­which var­i­ables ­had a prog­nos­tic ­impact on sur­vi­val ­and recur­rence ­rate.
Results. Patient ­age, ­sex, smok­ing hab­its ­and symp­toms ­were ­not dif­fer­en­tiat­ing char­ac­ter­is­tics ­when relat­ed to radio­graph­ic pres­en­ta­tion or to nat­u­ral his­to­ry. Mucinous ­cell-­type (23.6% of cas­es) ­was ­more fre­quent ­with ­non-smok­ers, pres­ence of a sin­gle nod­ule or ­mass ­and ­stage I. Favorable char­ac­ter­is­tics ­were: a) ­the prev­a­lence of ­stage I ­and N0 cas­es (59% ­and 76.7% of cas­es, respec­tive­ly) ­with a ­mean sur­vi­val ­time of 66 ­and 77 ­months, respec­tive­ly; ­and b) ­the radio­graph­ic pres­en­ta­tion of a sol­i­tary pul­mo­nary nod­ule or ­mass (76.4% of cas­es), ­that, inde­pen­dent­ly of ­nodal involve­ment, ­showed a high­er ­mean sur­vi­val ­time (62 ­months). Independently sig­nif­i­cant ­adverse prog­nos­tic fac­tors ­were: ­stage II-IV, ­lymph ­node involve­ment, ­and ­patient ­age ­over six­ty ­years. The radio­graph­ic pres­ence of mul­ti­ple or sat­el­lite nod­ules ­was relat­ed to a sig­nif­i­cant­ly ­adverse prog­no­sis (­mean sur­vi­val ­time: 18 ­months) by uni­var­i­ate anal­y­sis; ­this ­was ­not con­firmed by mul­ti­var­i­ate anal­y­sis.
Conclusions. In ­our expe­ri­ence ­BAC ­was ­the ­NSCLC sub­type ­more fre­quent­ly asso­ciat­ed ­with a ­good out­come ­after resec­tion; sur­gery ­should ­not to be ­denied ­also in ­patients ­with mul­ti­ple nod­ules, ­when ­under six­ty ­years of ­age ­and no ­lymph ­node involve­ment.

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