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Pier Luigi Filosso, MD*; Giovanni Donati, MD; Davide Turello, MD; Fausto Pernazza, MD; Alberto Oliaro, MD
Author and Funding Information

University of Torino Department of Thoracic Surgery, Castellamonte, Italy


Chest. 2005;128(4_MeetingAbstracts):139S. doi:10.1378/chest.128.4_MeetingAbstracts.139S-b
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PURPOSE:  To assess prognostic factors in patients operated on for bronchiolalveolar carcinoma (BAC) of the lung.

METHODS:  Between 1993 and 2000, 108 patients underwent pulmonary resection for BAC. There were 68 male (63%) and 40 female, mean age 63.8 years (range 29-77 years). Seventy-eight BACs (72.3%) were in the upper pulmonary lobes. Ninety-two lobectomies (85.2%) (69 upper), 7 pneumonectomies and 9 wedge-resections were carried out, and radical lymphadenectomy was always performed.

RESULTS:  Fifty-one tumors were less than 3 cm and 57 (52.8%) more than 3 cm in size. BACs resulted well- or middle-differentiated in 98 cases (91%). Microvascular, perineural and visceral pleural invasion were evident in 38, 6 and 26 cases respectively. Seventy-four tumours (68.5%) were at stage I, 10 at stage II, 22 at stage IIIa and 2 at stage IIIb. Three, 5 and 10 year survival rates were 66%, 63% and 55%, respectively.No survival differences were observed for age, gender, tumor grading, tumor size and visceral pleural involvement. Significant prognostic factors were microvascular invasion (p=0.01), perineural invasion (p=0.04), nodal status (p=0.007) and pathological staging (p=0.008).

CONCLUSION:  BACs show a better survival than others NSCLC, when radically resected. Microvascular and perineural invasions, nodal status and staging are significant factors in predicting long-term survival.

CLINICAL IMPLICATIONS:  an early stage BAC has a favourable long-term survival. A solitary pulmonary nodule in high risk patient, should be considered as a possible BAC. Early diagnosis and surgical treatment are thus mandatory.

DISCLOSURE:  Pier Luigi Filosso, None.

Monday, October 31, 2005

10:30 AM - 12:00 PM




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