- Volume 14 Issue 7
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Clinical Characteristics of Patients with Bronchioloalveolar Carcinoma: A Retrospective Study of 44 Cases
- Dirican, Nigar (Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital) ;
- Baysak, Aysegul (Department of Chest Diseases, Faculty of Medicine, Izmir University) ;
- Cok, Gursel (Department of Chest Diseases, Faculty of Medicine, Ege University) ;
- Goksel, Tuncay (Department of Chest Diseases, Faculty of Medicine, Ege University) ;
- Aysan, Tulin (Department of Chest Diseases, Faculty of Medicine, Ege University)
- Published : 2013.07.30
Background: Bronchioloalveolar carcinoma (BAC) is considered a subtype of adenocarcinoma of the lung. Recently BAC has been variously termed adenocarcinoma in situ, minimally invasive adenocarcinoma, lepidic predominant invasive adenocarcinoma, and invasive mucinous adenocarcinoma. The aim of the study was to analyze and detect prognostic factors of patients with BAC over a 7-year period. Materials and Methods: This retrospective single-center study included 44 patients with BAC. The impact on survival of fifteen variables (gender, age, smoking status, cough, dyspnea, hemoptysis, fever, chest pain, sputum, metastasis number, Karnofsky performance status, pT, pN, TNM stage, cytotoxic chemoterapy) were assessed. Results: Median age was 55 years (38-83). Most patients were male (63.6%) and stage IV (59.1%). Twenty-one patients (47.7%) received cytotoxic chemotherapy (platinum-based regimens) for metastatic disease. Objective response rate was 33.3% (4 partial, 3 complete responses). Stable disease was observed in nine in patients (42.8%). Disease progression was noted in 5 (23.8%). The median OS for all patients was 12 months (95%CI, 2.08-22.9 months). Independent predictors for overall survival were: Karnofsky performance status (HR:3.30, p 0.009), pN (HR:3.81, p 0.018), TNM stage (HR:6.49, p 0.012) and hemoptysis (HR:2.31, p 0.046). Conclusions: Karnofsky performance status, pN, TNM stage and hemoptysis appear to have significant impact on predicting patient survival in cases of BAC.
Bronchioloalveolar carcinoma;treatment;survival;prognostic factors
- AJCC Cancer Staging Manual, Seventh Edition (2010). published by Springer NewYork, Inc
- Barsky SH, Cameron R, Osann KE, et al (1994). Rising incidence of bronchioloalveolar lung carcinoma and its unique clinicopathologic features. Cancer, 73, 1163-70. https://doi.org/10.1002/1097-0142(19940215)73:4<1163::AID-CNCR2820730407>3.0.CO;2-J
- Bria E, Milella M, Sperduti I, et al (2009). A novel clinical prognostic score incorporating the number of resected lymph-nodes to predict recurrence and survival in non-smallcell lung cancer. Lung Cancer, 66, 365-71. https://doi.org/10.1016/j.lungcan.2009.02.024
- Brugger W, Triller N, Blasinska-Morawiec M, et al (2011). Prospective molecular marker analyses of EGFR and KRAS from a randomized, placebo-controlled study of erlotinib maintenance therapy in advanced non-small-cell lung cancer. J Clin Oncol, 29, 4113-20. https://doi.org/10.1200/JCO.2010.31.8162
- Cadranel J, Gervais M, Wislez P, et al (2011). IFCT-0504 trial: Mucinous and nonmucinous cytologic subtypes interaction effect in first-line treatment of advanced broncioloalveolar carcinoma by erlotinib or carboplatin/paclitaxel. J Clin Oncol, 29, 481. https://doi.org/10.1200/JCO.2010.34.4234
- Fukui T, Mori S, Yokoi K, et al (2006). Significance of the number of positive lymph nodes in resected non-small cell lung cancer. J Thorac Oncol, 1, 1220-5.
- Groome PA, Bolejack V, Crowley JJ, et al (2007). The IASLC lung cancer staging project: validation of the proposals for revision of the T, N, and M descriptors and consequent stage groupings in the forthcoming (seventh) edition of the TNM classification of malignant tumours. J Thorac Oncol, 2, 694-705. https://doi.org/10.1097/JTO.0b013e31812d05d5
- Hoang T, Xu R, Schiller JH, et al (2005). Clinical model to predict survival in chemonaive patients with advanced non-small-cell lung cancer treated with third-generation chemotherapy regimens based on eastern cooperative oncology group data. J Clin Oncol, 23, 175-83. https://doi.org/10.1200/JCO.2005.04.177
- Jemal A, Bray F, Center MM, et al (2011).Global cancer statistics. Cancer J Clin, 61, 69-90. https://doi.org/10.3322/caac.20107
- Johnson ML, Sima CS, Chaft J, et al (2013). Association of KRAS and EGFR mutations with survival in patients with advanced lung adenocarcinomas. Cancer, 119, 356-62. https://doi.org/10.1002/cncr.27730
- Kawaguchi T, Takada M, Kubo A, et al (2010). Performance status and smoking status are independent favorable prognostic factors for survival in non-small cell lung cancer: a comprehensive analysis of 26,957 patients with NSCLC. J Thorac Oncol, 5, 620-30.
- Kris MG, Giaccone G, Davies A, et al (2006). Systemic therapy of bronchioloalveolar carcinoma: Results of the first IASLC/ASCO consensus conference on bronchioloalveolar carcinoma. J Thorac Oncol, 1, 32-6. https://doi.org/10.1097/01243894-200611001-00007
- Lee BR, Yu JY, Ban HJ, et al (2012). Analysis of patients with hemoptysis in a tertiary referral hospital. Tuberc Respir Dis, 73, 107-14. https://doi.org/10.4046/trd.2012.73.2.107
- Lee JG, Lee CY, Park IK, et al (2008). Number of metastatic lymph nodes in resected non-small cell lung cancer predicts patient survival. Ann Thorac Surg, 85, 211-5. https://doi.org/10.1016/j.athoracsur.2007.08.020
- Miller VA, Hirsch FR, Johnson DH (2005). Systemic therapy of advanced bronchioloalveolar cell carcinoma: challenges and opportunities. J Clin Oncol, 23, 3288-93. https://doi.org/10.1200/JCO.2005.19.240
- Read WL, Page NC, Tierney RM, et al (2004). The epidemiology of bronchioloalveolar carcinoma over the past two decades: analysis of the SEER database. Lung Cancer, 45, 137-42. https://doi.org/10.1016/j.lungcan.2004.01.019
- Rosell R, Carcereny E, Gervais R, et al (2012). Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-smallcell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial. Lancet Oncol, 13, 239-46. https://doi.org/10.1016/S1470-2045(11)70393-X
- Rusch VW, Tsuchiya R, Tsuboi M, et al (2006). Surgery for bronchioloalveolar carcinoma and "very early" adenocarcinoma: An evolving standard of care? J Thorac Oncol, 1, 27-31. https://doi.org/10.1097/01243894-200611001-00006
- Scagliotti GV, Smit E, Bosquee L, et al (2005). A phase II study of paclitaxel in advanced bronchioloalveolar carcinoma (EORTC trial 08956). Lung Cancer, 50, 91-6. https://doi.org/10.1016/j.lungcan.2005.05.012
- Shaw AT, Kim DW, Nakagawa K, et al (2012). Crizotinib versus chemotherapy in advanced ALK-positive lung cancer. N Engl J Med, 368, 2385-94.
- Schiller JH, Harrington D, Belani CP, et al (2002). Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. N Engl J Med, 346, 92-8. https://doi.org/10.1056/NEJMoa011954
- Travis WD, Brambilla E, Noguchi M, et al (2011). International association for the study of lung cancer/american thoracic society/european respiratory society: international multidisciplinary classification of lung adenocarcinoma: executive summary. Proc Am Thorac Soc, 8, 381-5.
- West HL, Crowley JJ, Vance RB, et al (2005). Advanced bronchioloalveolar carcinoma: a phase II trial of paclitaxel by 96-hour infusion (SWOG 9714): a Southwest Oncology Group study. Ann Oncol, 16, 1076-80. https://doi.org/10.1093/annonc/mdi215
- Zhou C, Wu YL, Chen G, et al (2011). Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): a multicentre, openlabel, randomised, phase 3 study. Lancet Oncol, 12, 735-42. https://doi.org/10.1016/S1470-2045(11)70184-X
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