Carcinoma bronquioloalveolar, ¿Diagnóstico precoz?: Experiencia 1994-1997 en el Instituto Nacional del Tórax

Abstract

Bronchioloalveolar Carcinoma (BAC) at an early stage is presented as an asymptomatic peripheral nodule being stable for some years. Surgical treatment has up to 80% five years survival at this stage. Up to 50% of patients are diagnosed at this stage in developed countries by screening. BAC's prognosis is drastically worse at the phase of diffuse invasion of microcanaliculi. Our aim was to asses the early diagnosis of BAC in our institution. We study retrospectively these patients from our data base registry in a 4 years period (1994 to 1997). Fifteen out of 673 lung cancer patients had BAC as diagnosis (2.2%) which was confirmed by cytology or/and histology.Mean age of these patients was 64 years old, male/female ratio = 1.1 and 56.2% of them were heavy smokers. Two patients (13,3%) with a peripheral nodule were subjected to a lobectomy with a survival time of 56 and 30 months respectively. The other 13 patients received only palliative treatment with a mean survival time of 9 months. In this series age, sex and smoking were similar to other series. However, the number of asymptomatic patients diagnosed as peripheral nodule is clearly much lower in comparison to other series published (13 versus 50%). These results show the importance of screening to find more patients with BAC at the earliest stage. The frequency of patients in which BAC is diagnosed in stage of nodule, might reflect the quality of detection for lung cancer at any medical center