Study objective: Bronchioloalveolar carcinoma (BAC) is
an uncommon pulmonary neoplasm with various radiologic and clinical
presentations. In this article, we analyze the initial radiologic
findings, TNM stagings, surgical types, and radiologic features of
recurrence, and correlate them with patient survival.
Design: A retrospective review of 93 patients who underwent
resection for BAC from February 1989 to May 1999.
Patients: There were a total of 153 patients with BAC
diagnosed during this period. Among them, 60 patients (39.2%) had
diffuse disease and received medical therapy only, and the remaining 93
patients (60.8%), who had localized disease, underwent surgical
resection. Patients who received surgical resection were enrolled in
Measurements: Data regarding demographics,
presentation symptoms, initial radiologic features, surgical type,
tumor staging, recurrence status, radiologic patterns of recurrence,
and survival were obtained from all patients.
Female patients were significantly younger than male patients. Patients
who were female, nonsmoking, undergoing curative surgery, lobectomy, or
bilobectomy, and with early tumor staging and no nodal involvement had
a better prognosis. Patients with a right lung tumor had a longer
survival than those with a left lung tumor, with borderline
significance. Among those who suffered from recurrent diseases, a
second resection yielded a better survival. Multivariate analysis
showed curative surgery, initial surgical type, recurrence status,
radiologic patterns of recurrence, and duration from surgical resection
to recurrence all had a significant impact on survival.
Conclusions: Those patients with localized, early-stage BAC
who underwent curative surgery had a better survival. Patients with
localized recurrence after the initial surgery warranted a second
resection. Those with a diffuse radiologic pattern of recurrence and/or
early recurrence had a worse prognosis.