Surgery for bronchioloalveolar carcinoma and "very early" adenocarcinoma: An evolving standard of care? Journal Article
| Authors: | Rusch, V. W.; Tsuchiya, R.; Tsuboi, M.; Pass, H. I.; Grunenwald, D.; Goldstraw, P. |
| Article Title: | Surgery for bronchioloalveolar carcinoma and "very early" adenocarcinoma: An evolving standard of care? |
| Abstract: | Lobectomy and mediastinal lymph node dissection is the standard surgical management of early stage non-small cell lung cancer (NSCLC) because more limited resections have been associated with a higher risk of local recurrence. Nevertheless, recent lung cancer screening studies have led to the detection of an increasing number of "very early" NSCLC (defined as less than 2 cm in size) and of good-prognosis histologic subtypes, bronchioloalveolar carcinoma (BAC), and adenocarcinoma (AC), mixed subtypes that are potentially appropriate for sublobar resection. The precise indications for sublobar resection remain unclear and are the subject of ongoing clinical trials, but it seems that very early, peripherally located, node-negative AC of a predominantly BAC pattern may be adequately treated in this manner. Multifocal AC and BAC, either synchronous or metachronous, are also effectively treated by complete resection, using limited resections whenever possible. The pneumonic form of BAC, the rarest variant of this disease spectrum, continues to have a poor prognosis despite complete resection. Very limited experience suggests that lung transplantation leads to prolonged survival in highly selected patients with this histologic subtype. To improve our management of very early AC, much more information is needed about the molecular abnormalities of AC and their relationship to clinical outcomes. © 2006International Association for the Study of Lung Cancer. |
| Keywords: | immunohistochemistry; survival; cancer survival; treatment outcome; survival analysis; cancer surgery; surgical technique; clinical trial; mortality; review; cancer recurrence; cancer risk; systemic therapy; conference paper; cancer staging; methodology; lymph node dissection; lymph nodes; neoplasm staging; lymph node excision; lymphadenectomy; adenocarcinoma; computer assisted tomography; tumor volume; lung non small cell cancer; lung resection; lung neoplasms; pneumonectomy; cancer screening; pathology; histology; time; time factors; risk assessment; cancer invasion; lung tumor; survival time; cancer center; lung adenocarcinoma; early diagnosis; lymph node; intermethod comparison; lung alveolus cell carcinoma; neoplasm invasiveness; phase 3 clinical trial; cancer classification; mediastinum; lobectomy; lung transplantation; adenocarcinoma, bronchiolo-alveolar; clinical trials, phase iii |
| Journal Title: | Journal of Thoracic Oncology |
| Volume: | 1 |
| Issue: | Suppl.9 |
| ISSN: | 1556-0864 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2006-11-01 |
| Start Page: | S27 |
| End Page: | S31 |
| Language: | English |
| PUBMED: | 17409998 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 23" - "Export Date: 4 June 2012" - "Source: Scopus" |
