Annals of Oncology Advance Access originally published online on June 9, 2006
Annals of Oncology 2006 17(8):1255-1262; doi:10.1093/annonc/mdl121
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© 2006 European Society for Medical Oncology
Long-term survival differences for bronchiolo-alveolar carcinoma patients with ipsilateral intrapulmonary metastasis at diagnosis
1 Chao Family Comprehensive Cancer Center, Division of Hematology/Oncology; 2 Genetic Epidemiology Research Institute; 3 Division of Epidemiology, Department of Medicine, School of Medicine, University of California Irvine, Irvine, USA
* Correspondence to: Dr J. A. Zell, DO, MPH, Division of Hematology/Oncology, University of California Irvine Medical Center, 101 The City Drive South, Orange, CA 92868, USA. Tel: +1 (714) 456-5153; Fax: +1 (714) 456-2242; E-mail: jzell{at}uci.edu
Background: It has been suggested that the current staging system does not accurately reflect survival outcomes for advanced bronchiolo-alveolar carcinoma (BAC) patients.
Methods: We conducted a case-only analysis of US Surveillance, Epidemiology, and End Results (SEER) data (1998–2002). Overall survival (OS) and lung cancer-specific survival (LCSS) univariate analyses were conducted using the Kaplan-Meier method. Multivariate survival analyses were performed using Cox proportional hazards ratios.
Results: 2345 incident cases of BAC were analyzed, including 707 patients with stage IIIB or IV BAC. Patients with stage IIIB BAC due to multiple lesions in the same lobe (n = 93) had significantly improved median OS (46m) and LCSS (>58m) compared to other stage IIIB BAC patients (n = 111; OS = 9m, P < 0.0001; LCSS = 10m, P < 0.0001). Among stage IV BAC patients, those with intrapulmonary metastasis (n = 278) had significantly improved median OS (13m) and LCSS (15m) compared to those with distant metastasis (n = 225; OS = 7m, P < 0.0001; LCSS = 7m, P = 0.0001). These survival differences persisted after adjustment for age, gender, ethnicity, and surgical treatment status.
Conclusions: Among stage IIIB and IV BAC patients, those presenting with ipsilateral intrapulmonary metastasis have improved survival outcomes. Our results add further support for modification to the current staging system for BAC.
Key words: Bronchiolo-alveolar carcinoma, (BAC), epidemology, staging, survival
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