Tough call. Some might put it in the same category as another resected NSCLC tumor and give it, but noninvasive, pure BAC typically demonstrates a more favorable prognosis that might well be considered too favorable to justify the negative effects of post-operative chemo. There isn't any textbook answer here, and I think this is a case that merits an individual discussion of the potential pros and cons, fitness of the patient for chemo, their level of anxiety about cancer recurrence vs. chemotherapy, confidence that there is NO invasive component, etc. Overall, though, I think most general oncologists and lung cancer specialists would be less inclined to recommend adjuvant chemotherapy for someone with a non-invasive pure BAC than with just about any other lung cancer histology.
Thanks for the information. In this particular case I did not offer any systemic therapy. The way I see this tumor is sort of a dcis of the lung but with potentially more severe consequences.
Yes, and in fact the terminology is now shifting to BAC being referred to as "adenocarcinoma in situ" to reflect the similarity to ductal carcinoma in situ (DCIS) in the world of breast cancer.
Reply # - July 18, 2012, 07:39 PM
Reply To: Adjuvant therapy for nsclc
Tough call. Some might put it in the same category as another resected NSCLC tumor and give it, but noninvasive, pure BAC typically demonstrates a more favorable prognosis that might well be considered too favorable to justify the negative effects of post-operative chemo. There isn't any textbook answer here, and I think this is a case that merits an individual discussion of the potential pros and cons, fitness of the patient for chemo, their level of anxiety about cancer recurrence vs. chemotherapy, confidence that there is NO invasive component, etc. Overall, though, I think most general oncologists and lung cancer specialists would be less inclined to recommend adjuvant chemotherapy for someone with a non-invasive pure BAC than with just about any other lung cancer histology.
-Dr. West
Reply # - July 19, 2012, 05:20 PM
Reply To: Adjuvant therapy for nsclc
Thanks for the information. In this particular case I did not offer any systemic therapy. The way I see this tumor is sort of a dcis of the lung but with potentially more severe consequences.
Reply # - July 19, 2012, 08:59 PM
Reply To: Adjuvant therapy for nsclc
Yes, and in fact the terminology is now shifting to BAC being referred to as "adenocarcinoma in situ" to reflect the similarity to ductal carcinoma in situ (DCIS) in the world of breast cancer.
-Dr. West