title: Outcomes for lung transplantation for lung cancer in the United Network for Organ Sharing Registry.
abstract: BACKGROUND
  Advanced bronchoalveolar carcinoma (BAC) carries a poor prognosis, with median survival of approximately 1 year. More extended survivals have been reported after lung transplantation for BAC; however, fewer than 50 patients have been reported. To compare outcomes of lung transplantation for advanced BAC, we studied this population in a compulsory, prospectively maintained database.
  
  
  METHODS
  The United Network for Organ Sharing (UNOS) database was queried for patients undergoing lung transplant from 1987 to 2010 for the diagnosis of BAC or cancer. Pathology reports of explanted specimens were reviewed.
  
  
  RESULTS
  Twenty-nine patients underwent lung transplantation for BAC, representing 0.13% of the 21,553 lung transplants during the study period. BAC patients had better forced expiratory volume in 1 second percent predicted (60% vs 35%, p<0.0001) and received more double-lung transplants (79% vs 54%, p=0.006). Pure BAC was present in only 52% of the explants, whereas 41% had some degree of invasive tumor, and 7% had pure adenocarcinoma. The BAC and general lung transplantation cohorts had similar 30-day mortality (10% vs 7%, p=0.44) and 5-year survival (57% vs 50%, p=0.66).
  
  
  CONCLUSIONS
  Survival after lung transplantation for BAC appears to be consistent with that of lung transplantation for other diagnoses and is better than that reported with chemotherapy. Further study is warranted to identify the subgroup of patients with lung cancer who will have a maximum survival advantage after lung transplantation.
authors: Section of Thoracic Surgery, Department of Epidemiology, Yale University School of Public Health, New Haven, Connecticut 06520-8062, USA.
authors: Usman
authors: U
authors: Ahmad
authors: Zuoheng
authors: Z
authors: Wang
authors: Ayesha S
authors: AS
authors: Bryant
authors: Anthony W
authors: AW
authors: Kim
authors: Jasleen
authors: J
authors: Kukreja
authors: David P
authors: DP
authors: Mason
authors: Christian A
authors: CA
authors: Bermudez
authors: Frank C
authors: FC
authors: Detterbeck
authors: Daniel J
authors: DJ
authors: Boffa
mesh_terms: D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000704:Analysis of Variance; D002423:Cause of Death; D018572:Disease-Free Survival; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D017052:Hospital Mortality; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016040:Lung Transplantation / Q000379:methods / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D018579:Patient Selection; D011300:Preoperative Care; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D009927:Tissue and Organ Procurement; D016896:Treatment Outcome