BAC stage 1B lung cancer - 1261275

There's a lot written on the subject of post surgery chemo (adjuvant therapy). Consideration for adjuvant treatment becomes more weighted when the visceral pleura is involved. From his post about border line cases, http://cancergrace.org/lung/2007/10/02/factors-for-adj-chemo-in-borderl… Dr. West states, "Finally, another factor to consider is the involvement of the visceral pleura, the lining on the outside of the lung. This is reflected in the staging system, since even a smaller tumor that measures less than 3 cm becomes a stage IB NSCLC if it involves the visceral pleura. Here’s a survival curve from a series of stage I cancers that shows the difference in survival between those patients who had or did not have visceral pleural invasion (sometimes abbreviated VPI)".

And prob more direct info, http://cancergrace.org/lung/2012/05/15/modifying-factors-adjuvant-chemo…

I hope this helps with your understanding,
Janine

Janine, is this considered mucinous BAC, though I know they call it adeno now? Would treatment still be the same? I referred this person here to see what Dr. West would say about this situation.
Take care, Judy

Yeah, I saw BAC after I posted. Dr. West will likely comment this evening. If not I'll contact him.
Thanks and Happy New Year!

Bronchioloalveolar carcinoma (BAC) really refers to a non-invasive process. If it's invasive, there is really no specific place for tailoring a treatment recommendation for or against post-operative chemotherapy based on the name the pathologist gives it.

Making a recommendation for or against chemo just based on the vagaries of the staging system isn't how I or most other lung cancer experts approach the question of the potential value of post-operative chemotherapy. In the absence of lymph node involvement. the leading recommendation of a threshold for favoring chemo is 4 cm. I might use the presence of visceral pleural involvement (VPI) to nudge toward a recommendation in a highly motivated patient with a 3.5 cm tumor, but I would consider a 2 cm tumor with no lymph node involvement to be pretty far from an appropriate threshold for recommending chemotherapy, regardless of other features such as VPI.

-Dr. West

Thanks Dr. West. This is a good example of why I love this site so much...Professional insight in this world that knows no hard or fast rules.

Happy New Year!
Janine