Long-term Survival Analysis of Bronchioloalveolar Cell Carcinoma

Lee, Seung Hyun; Kim, Yong Hee; Moon, Hye Won; Kim, Dong Kwan; Kim, Jong Wook; Park, Seung Il

Abstract

BACKGROUND: Bronchioloalveolar carcinoma (BAC) is an uncommon primary malignancy of the lung, and it accounts for 2~14% of all pulmonary malignancies. According to World Health Organization (WHO) categorisation, BAC is a subtype of adenocarcinoma. The current definition of BAC includes the following: malignant neoplasms of the lung that have no evidence of extrathoracic primary adenocarcinoma, an absence of a central bronchogenic source, a peripheral parenchymal location, and neoplastic cells growing along the alveolar septa. Previous reports had demonstrated a better prognosis following surgery for patients affected by BAC than those affected by other type of non-small cell lung cancer (NSCLC). We aim to analyse Asan Medical Center experiences of BAC. MATERIAL AND METHOD: Between 1990 and 2002, 31 patients were received operations for BAC. We analyse retrosepectively sex, age, disease location, preoperative clinical stage, postoperative pathologic stage & complications, survival according to medical record. RESULT: There were 12 men and 19 women, the average age was 61.09+/-10.63 (31~79) years. Tumor locations were 7 in RUL, 1 in RML, 4 in RLL, 8 in LUL, 11 in LLL. Operations were 28 lobectomies, 2 pneumonectomies. Postoperative pathologic stage were 12 T1N0M0, 15 T2N0M0, 1 T1N1M0, 1 T1N2M0, 1 T2N2M0, 1 T1N0M1. Mortality were 4 cases (12.9%) and there were no early mortality. Cancer free death was 1 cases, other 3 were cancer related deaths. All of them were affected by distal metastasis and received chemotherapy and each metastatic locations were right rib, brain, and both lung field. The average follow up periods were 50.87+/-24.77 months. The overall 3, 5-year survival rate among all patients was 97.1%, 83.7%, stage I patients overall 2, 5-year survival rate was 96.3%. The overall disease free 1,2, 5-year survival rate among all patients was 100%, 90%, 76% and 2, 5-year survival rate in cases of stage I was 96.4%, 90.6%. 7 cases (22.58%) were chemotherapies, 1 case (3.22%) was radiation therapy, and 2 cases (6.45%) were chemoradiation therapies. Metastatic locations were 3 cases in lung, 1 case in bone, 1 cases in brain.
CONCLUSION
BAC has a favourable survival and low recurrence rate compare with reported other NSCLC after operative resections.