Bronchioloalveolar lung cancer: occurrence, surgical treatment and survival

• Published in: European journal of cardio-thoracic surgery Vol. 23; no. 5; pp. 818 - 823
• Main Authors: Furák, József, Troján, Imre, Szőke, Tamás, Tiszlavicz, László, Morvay, Zita, Eller, József, Balogh, Ádám
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Science B.V 01-05-2003; Elsevier Science
• Subjects: Adenocarcinoma, Bronchiolo-Alveolar - mortality; Adenocarcinoma, Bronchiolo-Alveolar - pathology; Adenocarcinoma, Bronchiolo-Alveolar - surgery; Adult; Aged; Biological and medical sciences; Bronchioloalveolar carcinoma; Female; Humans; Hungary - epidemiology; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Lung Neoplasms - surgery; Male; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - mortality; Pneumology; Prevalence; Regression Analysis; Retrospective Studies; Scar-carcinoma; Smokers; Survival; Survival Analysis; Survival Rate; Tumors of the respiratory system and mediastinum; Hungary; Smokers; Survival; Scar-carcinoma; Bronchioloalveolar carcinoma; Human; Lung disease; Prognosis; Respiratory disease; Lung cancer; Tobacco smoking; Bronchopulmonary malignant tumor; Treatment; Smoker; Surgery; Bronchus disease
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/S1010-7940(03)00084-8

Objective: The prevalence of pulmonary adenocarcinoma has risen worldwide. Bronchioloalveolar carcinoma (BAC) was studied with regard to whether it exhibits a similar tendency, and its typical features were analysed. Methods: Between 1992 and 2001, 278 lung resections were carried out for adenocarcinoma. Of these, 67 (24.1%) proved to involve BAC. Whereas BAC accounted for 6.9% of the cases in 1992, in 2001 the proportion was 46.9%. There were 37 men (55.2%) and 30 women (44.7%); the average age was 60.5 years. 58.2% of them had no complaints. Of the 26 non-smokers, 69.2% were women; of the 41 smokers, 29.2% were women. In consequence of the tumour, 49 lobectomies, three bilobectomies, six pneumonectomies and nine wedge resections were performed. Results: The surgical mortality was 1.6%. The pathology revealed that 26 (38.8%) tumours were in stage I/A. In 15 cases (22.4%), tuberculosis (TB) could be revealed besides the BAC: by skin tests in four cases, by CT in three cases, by case history in four cases, and by pathology in four cases. For the overall group of 67 patients, the 5-year survival rate was 61.9%, and the mean survival time was 75.7 months. The 5-year survival rate among the women (74%) was significantly better than that among the men (37%) (P=0.030). There was no significant difference in survival with regard to the multiple BAC (85%). The 5-year survival rate was significantly worse in the mixed BAC group (20%) than in the non-mucinous (62.7%) and in mucinous (59%) group. The overall 5-year survival rate among the smokers and TB patients was 61 and 79%, respectively, which is higher than that among the non-smokers (47%) and non-TB patients (56%). The survival rate for the wedge resection cases was 37%, which was lower than that for the cases involving major resections (60%) (P=0.939). Conclusion: BAC has a favourable survival, particularly in women. In spite of this, resection smaller than lobectomy is recommended only as a compromise. A multiple appearance does not imply a worse survival. The best survival rate was found in the non-mucinous BAC among the histological groups. TB seems to be frequent among BAC patients.