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The Annals of Thoracic Surgery, Vol 51, 368-376, Copyright © 1991 by The Society of Thoracic Surgeons
RC Daly, VF Trastek, PC Pairolero, PA Murtaugh, MS Huang, MS Allen and TV Colby
One hundred thirty-four consecutive patients (65 men and 69 women)
underwent pulmonary resection for bronchoalveolar carcinoma. Mean age was
65 years. Lobectomy was done in 100 patients, pneumonectomy in 10,
segmentectomy in 5, and wedge excision in 19. Only 10 patients had lymph
node metastases (7.5%). The neoplasm was solitary in 111 patients (82.8%);
97 were in stage I, 4 were in stage II, 9 were in stage IIIa, and 1 was in
stage IIIb. There were two operative deaths (1.5%). Thirty- nine
complications occurred in 31 patients. Median follow-up was 5.1 years.
Recurrent bronchoalveolar carcinoma developed in 45 patients. Five- and
10-year survival for patients in stage I was 75.2% and 62.0%, respectively.
Survival for patients with T1 N0 M0 neoplasms was identical to expected
survival and was 90.5% at 5 years, as compared with 55.4% for patients with
T2 N0 M0 disease, only 35.9% for patients with multiple bilateral disease,
and 0.0% for patients with bilateral disease (p less than 0.0001). Other
significant factors adversely affecting survival included the presence of
signs and symptoms, diffuse malignant invasion, mucin-producing tumors, and
the histological absence of scar. We conclude that bronchoalveolar
carcinoma has a unique natural history that is more influenced by local
neoplastic processes than by lymph node metastases. Early aggressive
pulmonary resection is safe and offers the potential for cure. The presence
of bilateral cancer, however, is ominous.
ARTICLES
Bronchoalveolar carcinoma: factors affecting survival
Section of General Thoracic Surgery, Mayo Clinic, Rochester, Minnesota 55905.
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