Clinical presentation, treatment options and outcome in patients with bronchioloalveolar carcinoma

To determine the characteristics of bronchioloalveolar carcinoma (BAC) as a special clinical and pathological entity and to evaluate the effects of treatment options on survival of BAC patients.

The study was partially retrospective and partially prospective, non randomized. We evaluated the clinical presentation, smoking habits, radiographic findings, treatment and survival of 21 patients with BAC treated at our Institute from 2000-2004.

Registered were 16 (76.2%) male and 5 (23.8%) female patients, most of them in the 6th and 7th decade of life. Among younger patients females prevailed. Most common symptoms were dyspnoea 15 (71.4%), cough 14 (66.6%) and bronchial hypersecretion 9 (42.8%). There were 5 (23.8%) smokers, 6 (28.6%) ex-smokers and 10 (47.6%) nonsmokers. Main radiographic findings were lung consolidation (9; 42.8%), diffuse interstitial infiltrates (6; 28.6%), solitary (4; 19.0%) and multiple pulmonary lesions (2; 9.5%). Surgery was performed in 8 (38.0%) patients and 5 of them received adjuvant radio- and chemotherapy, while the remaining received chemotherapy alone (9; 42.8%) and symptomatic treatment (4; 19.0%). The median survival was 25 months and 1-year survival 70%, regardless of stage. In the group of patients treated surgically 1- and 2-year survival rate was 100% and the median survival 33 months. In non-operated patients the median survival was 18 months and 1- and 2-year survival 55% and 25%, respectively.

BAC is a special clinical and pathological form of adenocarcinoma of the lung. Surgical treatment is the best option for selected BAC patients. Survival is associated with the treatment modality. Larger scale studies are necessary to confirm these findings.