P3-208: Clinical features and treatment outcome of bronchioloalveolar carcinoma defined by who classification

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Bronchioloalveolar carcinoma (BAC) is defined as an adenocarcinoma with pure bronchioloalveolar growth pattern and no evidence of stromal, vascular or pleural invasion by 1999 WHO classification. Although BAC has unique clinical and radiological presentations, BAC has been defined inconsistently in various series. We analyzed the clinical features, treatment outcome and prognostic factors of 141 BAC patients in a single institution. From September 1994 to December 2004, a total of 5,063 patients were diagnosed of non-small lung cancer (NSCLC) at Samsung Medical Center in Korea. Of 5,063 patients, 141 patients (2.8% of NSCLC, 5.2% of adenocarcinoma) were diagnosed of BAC according to the 1999 WHO criteria. The clinical data including radiological features, treatment modalities, relapse and vital status were retrospectively obtained. Among the 141 patients, 100 patients (71%) underwent surgical resection with curative intent. The male to female ratio was 0.85:1 and the median age was 62 years (range, 29 - 83). Only 29% of the patients were current or ex-smokers. Most patients (61%) had clinicopatholgic stage I, 5% stage II, 8% stage III, and 26% of the patients presented with stage IV disease. The most common initial radiological presentation was solitary nodule (63%) followed by multiple nodules in both lungs (18%), infiltrating or pneumonic mass (9%), multiple nodules in the same lung (6%), and a cavitary mass (4%). The most frequent location of the tumor was the right upper lobe (28%) followed by the right lower lobe (17%), the left lower lobe (16%), the left upper lobe (9%), and the right middle lobe (6%). The estimated 5-year overall survival rate of the 100 patients who underwent surgical resection was 71.4 %, and the median survival has not been reached yet. Among the resected patients, 24 patients de-veloped relapse mostly in the lung (19 patients, 78%). The median survival was 6.9 months for the 39 patients without surgical resection. At the multivariate analysis, initial radiological presentation with solitary nodule and curative resection were favorable prognostic factors for survival. Pure BAC is uncommon lung adenocarcinoma in Korea. Patients with localized, resectable disease and initial radiological finding of solitary nodule have a significantly better survival.