Early results of a prospective study of limited resection for bronchioloalveolar adenocarcinoma of the lung

Yamato, Yasushi; Tsuchida, Masanori; Watanabe, Takeshi; Aoki, Tadashi; Koizumi, Noriko; Umezu, Hajime; Hayashi, Jun‐Ichi

doi:10.1016/s0003-4975(00)02507-8

Cited by 134 publications

(80 citation statements)

References 13 publications

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“…Because BAC has lower rates of regional lymph node involvement than do other lung cancers, several groups of investigators have studied the possibility of performing less aggressive resections of lung cancer in patients with pure BAC. Investigators have found equivalent oncologic outcomes in comparison with lobar resections (15)(16)(17)(18)(19). Arenberg and the American College of Chest Physicians in ''Bronchioloalveolar Lung Cancer: ACCP Evidence-Based Clinical Practice Guidelines'' in 2007 recommended sublobar resection of pure BAC (20).…”

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confidence: 99%

Diagnosis and Differentiation of Bronchioloalveolar Carcinoma from Adenocarcinoma with Bronchioloalveolar Components with Metabolic and Anatomic Characteristics Using PET/CT

Goudarzi

Jacene²,

Wahl³

2008

J Nucl Med

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18 F-FDG PET has been reported to have reduced sensitivity in detecting bronchioloalveolar carcinoma (BAC) versus lung cancers with other histologies. However, there are CT characteristics that are suggestive of BAC, and potentially these could be useful to refine diagnostic criteria so PET/CT can be more accurate in the diagnosis of BAC. We correlated tumor size and density obtained with CT and glucose metabolism obtained with 18 F-FDG PET in patients with BAC and adenocarcinoma with BAC components (Adeno1BAC) to determine the roles of both the anatomic and the functional components of the PET/CT examination in diagnosing this disease. Also, the correlation between tumor size and 18 F-FDG uptake or Hounsfield unit (HU) value was determined in these 2 groups. Methods: This was a retrospective study on a consecutive series of 53 patients with 57 pathology-proven lesions (26 BAC, 31 Adeno1BAC) who underwent 18 F-FDG PET/CT scans. The standardized uptake value (SUV) and average HUs reported were obtained for the tumors. The tumor size, 18 F-FDG uptake, and HU values in both groups were compared. The correlation between metabolic (SUV) and CT (HU) characteristics for the lesions and tumor size was assessed using the Pearson correlation coefficient. Results: A total of 26 lesions with pure BAC had a median SUVmax of 1.48 (range, 0.63-4.54). A total of 81% of patients with BAC (21/26 lesions) had SUVmax values of less than 2.5. Thirty-one lesions diagnosed as Adeno1BAC had a median SUVmax of 6.03 (range, 2.45-24) (P , 0.0001 vs. BAC). The mean SUVmax (1.77 6 0.99) of BAC was much lower than that of Adeno1BAC (6.55 6 4.33) (P , 0.0001). Maximum HU in BAC lesions (2111.96 6 123.92) was substantially lower than that in Adeno1BAC (82.03 6 33.77) lesions (P , 0.0001). The average maximum tumor dimension in the lung window was much smaller for BACs (17.63 6 5.5) than for Adeno1BACs (49.38 6 27.5) (P , 0.0001). A strong positive correlation between tumor size and HU was observed in the Adeno1BAC group (P 5 0.0002). Conclusion: PET/CT can help differentiate between BAC and Adeno1BAC by using tumor size, CT density, and metabolic activity. Pure BAC exhibits smaller size, lower 18 F-FDG uptake, and lower tumor density than does Adeno1BAC. Many BACs have low SUVs (,2.0), but their low HU on CT aids in their proper identification.

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confidence: 99%

Diagnosis and Differentiation of Bronchioloalveolar Carcinoma from Adenocarcinoma with Bronchioloalveolar Components with Metabolic and Anatomic Characteristics Using PET/CT

Goudarzi

Jacene²,

Wahl³

2008

J Nucl Med

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“…BAC is a unique pattern of lung cancer which expresses subtle but distinctive features based on the age of the patient, sex ratio, cyto -and histopathology of the tumor, growth rate, progression, and prognosis. The mean age of patients with BAC is younger than that of patients with non -BAC lung carcinoma by 5 years 16,17) . Our findings disclosed that the incidence of BAC was predominant in female but other studies showed various male to female ratios 18,19) .…”

Section: Discussionmentioning

confidence: 97%

Interphase Cytogenetic Analysis of Lung Adenocarcinomas With Bronchioloalveolar Pattern

Shimizu

Sugino

Chiba

2012

FJMS

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: Aneuploidy has been suggested as a marker for stratification of many neoplasms but its potential usefulness in adenocarcinoma (ADC) with bronchioloalveolar (BAC) pattern has not been well defined. We examined paraffin -embedded tissue sections from 28 cases of ADC with BAC pattern as well as 7 benign lung lesions and 9 normal lung tissue samples for chromosomal aneuploidy by in situ hybridization using digoxigenin -labelled probes for chromosomes 1 and X.Of the 28 ADC with BAC pattern, 17 (61%) were diploid and 11 (39%) were aneuploid. Of the 17 diploid cases, 7 (41%) were male and 10 (59%) were female and of the 11 aneuploid cases, 2 (18%) were male, 9 (82%) were female. Regarding the cell type, 24 (86%) were adenocarcinomas in situ (AIS) so called BAC and minimally invasive ADC (MIA), and 4 cases (14%) were invasive ADC. Of the 12 cases each of AIS and MIA, 9 (75%) and 8 (67%) had diploid pattern respectively. Of the 4 invasive ADC cases, all had aneuploid pattern. Seventeen cases (71%) with T1 tumor size (>0 mm 30 mm), had diploid and 4 cases (100%) with T2 tumor size (>30 mm 70 mm) had aneuploid pattern. Statistical analyses showed that nuclear diploidy was significantly correlated with AIS and MIA tumor types while aneuploidy correlated with invasive ADC type (P=0.025). Also a significant correlation was found between ploidy and tumor size (P=0.033).In conclusion, these findings suggest that DNA ploidy analysis provides useful information for the assessment of cellular kinetics and reflect histopathological subtypes in ADC with BAC pattern that are destined to behave aggressively.

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“…The authors stated that they had reviewed 11 thousand citations from which they selected 312 that 'met specified eligibility.' The citations supporting their notion, interestingly, have been presented as series of bronchioloalveolar carcinomas or small adenocarcinomas (o2 cm) [29][30][31][32][33][34][35][36][37][38][39][40][41] (Table 5). In some of these, the actual size of the tumor has been at best vague leaving the impression that some of these lesions may not even qualify as adenocarcinoma, but would rather have to be classified as atypical adenomatous hyperplasia (tumors with lepidic growth and size r0.5 cm).…”

Section: Discussionmentioning

confidence: 97%

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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Early results of a prospective study of limited resection for bronchioloalveolar adenocarcinoma of the lung

Cited by 134 publications

References 13 publications

Diagnosis and Differentiation of Bronchioloalveolar Carcinoma from Adenocarcinoma with Bronchioloalveolar Components with Metabolic and Anatomic Characteristics Using PET/CT

Diagnosis and Differentiation of Bronchioloalveolar Carcinoma from Adenocarcinoma with Bronchioloalveolar Components with Metabolic and Anatomic Characteristics Using PET/CT

Interphase Cytogenetic Analysis of Lung Adenocarcinomas With Bronchioloalveolar Pattern

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

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