Clinical pattern and pathologic stage but not histologic features predict outcome for bronchioloalveolar carcinoma Journal Article

Authors: Ebright, M. I.; Zakowski, M. F.; Martin, J.; Venkatraman, E. S.; Miller, V. A.; Bains, M. S.; Downey, R. J.; Korst, R. J.; Kris, M. G.; Rusch, V. W.
Article Title: Clinical pattern and pathologic stage but not histologic features predict outcome for bronchioloalveolar carcinoma
Abstract: Background. The histologic criteria defining bronchioloalveolar carcinoma (BAC) were recently revised, but it is unclear whether these criteria predict clinical behavior. This study determined the outcome of resected BAC in relationship to clinical and radiologic disease pattern, and pathologic features. Methods. Between 1989 and 2000, 100 consecutive surgically treated patients with adenocarcinomas exhibiting various degrees of BAC features were retrospectively studied. Histology was reviewed; tumors were classified as pure BAC, BAC with focal invasion, and adenocarcinoma with BAC features. Clinical and radiologic pattern were classified as unifocal, multifocal, or pneumonic. Demographic data, tumor stage, and outcome were recorded. Survival was analyzed by the Kaplan-Meier method, and prognostic factors were determined by the log-rank test. Results. Patient median age was 65, and 74% of the patients were female. Pure BAC, BAC with focal invasion, and adenocarcinoma with BAC features occurred in 47, 21, and 32 patients, respectively. Unifocal disease occurred in 64 patients, multifocal in 29, and pneumonic in 7. Seventy-one patients had stage I/II tumors, 22 had stage III/IV, and 7 patients had Stage X tumors. Overall 5-year survival was 74%. There was no significant difference in survival among the three histologic subtypes. The pneumonic pattern had significantly worse survival compared with unifocal and multifocal patterns. Pathologic stage predicted survival, with 5-year survivals for I/II and III/IV of 83.7% and 59.6%, respectively. Conclusions. Clinical pattern and pathologic stage, but not the degree of invasion on histologic examination predict survival. Multifocal disease is associated with excellent long-term survival after resection. The favorable survival of stage III/IV BAC indicates that the current staging system does not fully describe this disease in patients undergoing resection because of its distinct tumor behavior. © 2002 by The Society of Thoracic Surgeons.
Keywords: adult; cancer survival; human tissue; aged; aged, 80 and over; middle aged; survival rate; major clinical study; clinical feature; cancer staging; neoplasm staging; lung neoplasms; pneumonectomy; relapse; histology; cancer invasion; lung metastasis; lung; lung carcinoma; lung alveolus cell carcinoma; neoplasm invasiveness; cancer classification; adenocarcinoma, bronchiolo-alveolar; humans; prognosis; human; male; female; priority journal; article
Journal Title: Annals of Thoracic Surgery
Volume: 74
Issue: 5
ISSN: 0003-4975
Publisher: Elsevier Science, Inc.  
Date Published: 2002-11-01
Start Page: 1640
End Page: 1647
Language: English
DOI: 10.1016/s0003-4975(02)03897-3
PUBMED: 12440623
PROVIDER: scopus
Notes: Presented at the 38th Annual Meeting of The Society of Thoracic Surgeons; 2002 Jan 28-30; Ft Lauderdale, FL -- Export Date: 14 November 2014 -- Source: Scopus
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MSK Authors
  1. Venkatraman Ennapadam Seshan
    303 Seshan
  2. Robert J Korst
    26 Korst
  3. Valerie W Rusch
    693 Rusch
  4. Michael Irwin Ebright
    13 Ebright
  5. Jocelyne Martin
    7 Martin
  6. Vincent Miller
    268 Miller
  7. Maureen F Zakowski
    283 Zakowski
  8. Robert J Downey
    208 Downey
  9. Manjit S Bains
    242 Bains
  10. Mark Kris
    667 Kris