title: Prognosis and recurrent patterns in bronchioloalveolar carcinoma.
abstract: OBJECTIVE
  Bronchioloalveolar carcinoma (BAC) is an uncommon pulmonary neoplasm with various radiologic and clinical presentations. In this article, we analyze the initial radiologic findings, TNM stagings, surgical types, and radiologic features of recurrence, and correlate them with patient survival.
  
  
  METHODS
  A retrospective review of 93 patients who underwent resection for BAC from February 1989 to May 1999.
  
  
  METHODS
  There were a total of 153 patients with BAC diagnosed during this period. Among them, 60 patients (39.2%) had diffuse disease and received medical therapy only, and the remaining 93 patients (60.8%), who had localized disease, underwent surgical resection. Patients who received surgical resection were enrolled in this study.
  
  
  METHODS
  Data regarding demographics, presentation symptoms, initial radiologic features, surgical type, tumor staging, recurrence status, radiologic patterns of recurrence, and survival were obtained from all patients.
  
  
  RESULTS
  Female patients were significantly younger than male patients. Patients who were female, nonsmoking, undergoing curative surgery, lobectomy, or bilobectomy, and with early tumor staging and no nodal involvement had a better prognosis. Patients with a right lung tumor had a longer survival than those with a left lung tumor, with borderline significance. Among those who suffered from recurrent diseases, a second resection yielded a better survival. Multivariate analysis showed curative surgery, initial surgical type, recurrence status, radiologic patterns of recurrence, and duration from surgical resection to recurrence all had a significant impact on survival.
  
  
  CONCLUSIONS
  Those patients with localized, early-stage BAC who underwent curative surgery had a better survival. Patients with localized recurrence after the initial surgery warranted a second resection. Those with a diffuse radiologic pattern of recurrence and/or early recurrence had a worse prognosis.
authors.affiliation: Chest Department, Veterans General Hospital-Taipei, and National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC.
authors.forename: Y Y
authors.initials: YY
authors.lastname: Liu
authors.forename: Y M
authors.initials: YM
authors.lastname: Chen
authors.forename: M H
authors.initials: MH
authors.lastname: Huang
authors.forename: R P
authors.initials: RP
authors.lastname: Perng
mesh_terms: D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000401:mortality; D011013:Pneumonectomy; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D015996:Survival Rate