A comparison of survival and disease‐specific survival in surgically resected, lymph node‐positive bronchioloalveolar carcinoma versus nonsmall cell lung cancer

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Abstract
BACKGROUND: The objective of this study was to assess whether disease‐specific survival (DSS) and overall survival (OS) differed among patients who had N1 and N2 bronchioloalveolar carcinoma (BAC) compared with patients who had non‐BAC nonsmall cell lung cancer (NSCLC).METHODS: The Surveillance, Epidemiology, and End Results (SEER) Program database from 1992 to 2002 contained 684 patients with BAC and 9809 patients with non‐BAC NSCLC who had N1/N2 tumors and who underwent a definitive surgical procedure. OS and DSS rates were compared according to potential prognostic factors, including the use of a matched‐pair analysis.RESULTS: The BAC patients with either pathologic N1 or N2 lymph node status were significantly more likely to be women, and nonblack/nonwhite race, but significantly less likely to have poorly differentiated or undifferentiated tumors than patients with non‐BAC cancers with comparable lymph node status. The median follow‐up of all patients was 29 months. There was a significant difference in DSS between patients with N2 BAC and non‐BAC cancers, but not for patients with N1 disease. There was a nonsignificant trend toward longer OS for patients with N2 BAC compared with non‐BAC cancers.CONCLUSIONS: Patients with lymph node‐positive BAC had distinctly different patient and tumor characteristics than patients with lymph node‐positive non‐BAC NSCLC. Because DSS appears to be better for patients with N2 BAC, they may not benefit as much from adjuvant therapy as patients with non‐BAC NSCLC. Cancer 2008. ©2008 American Cancer Society.

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