Metastatic Bronchioloalveolar Carcinoma and Metastatic Adenocarcinoma of the Lung: Comparison of Clinical Manifestations, Chemotherapeutic Responses, and Prognosis

Feldman, Edward R.; Eagan, Robert T.; Schaid, Daniel J.

doi:10.1016/s0025-6196(12)60273-0

Cited by 44 publications

(28 citation statements)

References 15 publications

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“…In contrast to our findings, those authors reported that 223 patients with metastatic adenocarcinoma lived longer (6 months) than the 25 patients with metastatic BAC (4 months), although statistical significance was not reached (P ϭ 0.64). 29 However, their patients are not directly comparable to the patients reported here, because the majority of their patients with BAC had been treated previously, and one-third of the patients had a poor performance status (2 or 3). Potential explanations for the prolonged survival in our BAC patients compared with prior reports of patients with similar stages of BAC include more selective efficacy of paclitaxel for the treatment of patients with BAC (received by 71% of BAC patients), more asymptomatic patients at initial presentation (14% vs. 4%), more patients with good performance status, and less common prior surgical resection rates (10% vs. 39 -44%).…”

Section: Discussionmentioning

confidence: 57%

“…Potential explanations for the prolonged survival in our BAC patients compared with prior reports of patients with similar stages of BAC include more selective efficacy of paclitaxel for the treatment of patients with BAC (received by 71% of BAC patients), more asymptomatic patients at initial presentation (14% vs. 4%), more patients with good performance status, and less common prior surgical resection rates (10% vs. 39 -44%). 29,40 A longer natural history also may contribute to the prolonged survival observed in these patients with BAC.…”

Section: Discussionmentioning

confidence: 99%

“…19,29,34,36 The other studies of 9 -40 patients with advanced BAC reported median survivals of 3-18 months, but their survival information is difficult to interpret, because they did not present survival information about comparable patients with other types of NSCLC. 34,36,39 The survival of patients with Stage I-III BAC also appears to be longer than for patients with other types of NSCLC.…”

Section: Discussionmentioning

confidence: 99%

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Clinical features of patients with stage IIIB and IV bronchioloalveolar carcinoma of the lung

Breathnach

Ishibe

et al. 1999

Cancer

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical features of patients with stage IIIB and IV bronchioloalveolar carcinoma of the lung

Breathnach

Ishibe

et al. 1999

Cancer

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“…Historically, the term has been under much debate and different views have been presented to attest to its clinical behavior without, however, producing a unifying agreement. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] In 1960, Liebow 20 introduced the term bronchioloalveolar carcinoma to describe a well-differentiated adenocarcinoma that may have long dormancy or slow growth, particularly in those patients presenting with isolated nodules. More recently and exclusively looking at the solitary nodule pattern, there have been proposals for a change in the nomenclature of pulmonary adenocarcinomas with a pure lepidic or bronchioloalveolar growth pattern.…”

Section: Discussionmentioning

confidence: 99%

Early-stage pulmonary adenocarcinoma (T1N0M0): a clinical, radiological, surgical, and pathological correlation of 104 cases. The MD Anderson Cancer Center Experience

et al. 2013

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The recent proposal for histological subtyping of pulmonary adenocarcinoma by predominant pattern and introduction of the terms adenocarcinoma in situ and minimally invasive adenocarcinoma to replace the term bronchioloalveolar carcinoma by the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society has led us to conduct a study of 104 patients with early-stage primary pulmonary adenocarcinoma (T1N0M0), with a view to histological subtype as defined by the new proposal and clinical outcome. None of the clinical parameters of our patient population (type of surgery, age, gender, tumor size, and comorbidities) showed any statistically significant correlation with outcome, except for associated malignancies, which not surprisingly appeared to have a negative impact on survival. In addition, statistical analyses of the histological characteristics to include tumor differentiation and the percentage of a lepidic or bronchioloalveolar component did not show any statistically significant values in terms of survival. Our results failed to show any statistically significant difference of survival between those T1N0M0 adenocarcinomas with a lepidic component and those without, thus questioning the use of terms such as in situ or minimally invasive adenocarcinoma. On the basis of our results, we consider that the outcome for patients with T1N0M0 disease is still best determined by appropriate staging rather than by changes in the pathology nomenclature of adenocarcinoma. The number of deaths due to lung cancer among this group was approximately 158 thousand. Also according to SEER, the age group more commonly affected is individuals between the ages of 55 and 74 years, with a median age at diagnosis of 71 years. Although lung cancer is also seen in younger age groups, people under 45 years of age represent approximately 2% of the total number of cases, while those people between the ages of 45 and 54 years represent approximately 9% of the total number of cases. It is also suggested that factors such as smoking, dietary habits, family history, and chemical exposure to compounds such as asbestos, radon, and silica among many others may play a role in lung cancer pathogenesis. Of all the different types of lung cancer, adenocarcinoma is currently the most frequent.In an effort to better define clinical behavior regarding small size adenocarcinomas, various studies have used different ways to address this issue.

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“…BAC is more common among women compared to men, and up to one third of BAC patients are nonsmokers, as compared with 10% of patients with other forms of non-small cell lung cancer [2, 3, 4, 5]. Patients with BAC more frequently develop metastases or recurrences within the lung without obvious extrapulmonary involvement compared to those patients with other types of adenocarcinoma or non-small cell lung cancer [6, 7]. Survival is longer in patients with both early- and late-stage BAC than in patients with other types of adenocarcinomas of similar stage [5, 8].…”

Section: Introductionmentioning

confidence: 99%

Genetic Changes in Contralateral Bronchioloalveolar Carcinomas of the Lung

et al. 2000

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Objective: The pattern of metastases and recurrence of bronchioloalveolar carcinoma (BAC) differs from adenocarcinoma of the lung, occurring more frequently within the lung without extrapulmonary involvement. Analyses of genetic differences of contralateral BACs may help to explain these clinical differences. Methods: We compared paired tumors from 5 patients with contralateral metachronous BACs for loss of heterozygosity (LOH) on 6 chromosomal arms (2q, 3p, 5q, 9p, 13q and 17p) and mutational analysis of p53 and K-ras. Results: Two patients, patients 1 and 2, had discordant patterns of LOH on 2 and 3 of the chromosome arms, respectively. In addition, patient 2 had a detectable K-ras mutation in his initial tumor but not in his second. These results suggest that in patients 1 and 2, the contralateral tumors were clonally unrelated. Patient 3 had no mutations in the K-ras or p53 gene and no LOH on any of the 5 informative chromosome arms. Patient 4 had LOH of 9p and mutated K-ras in both the first and the second tumor, with a mutation in the p53 gene in the first but not in the second tumor. Patient 5 had LOH of 17p and the same p53 mutations in both the first and the second tumor, with a mutation of K-ras in the first tumor but not in the second. Conclusions: The preponderance of evidence suggests that in patients 3, 4 and 5, the paired tumors were clonally related. The different patterns of LOH and mutations in clinically similar contralateral metachronous BACs provide evidence of genetic heterogeneity in the tumors of this patient group.

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Metastatic Bronchioloalveolar Carcinoma and Metastatic Adenocarcinoma of the Lung: Comparison of Clinical Manifestations, Chemotherapeutic Responses, and Prognosis

Cited by 44 publications

References 15 publications

Clinical features of patients with stage IIIB and IV bronchioloalveolar carcinoma of the lung

Clinical features of patients with stage IIIB and IV bronchioloalveolar carcinoma of the lung

Early-stage pulmonary adenocarcinoma (T1N0M0): a clinical, radiological, surgical, and pathological correlation of 104 cases. The MD Anderson Cancer Center Experience

Genetic Changes in Contralateral Bronchioloalveolar Carcinomas of the Lung

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