A review of Tracheobronchial Adenoid Cystic Carcinoma: treatment methods and outcomes. (Preprint)

Abstract

BACKGROUND Adenoid cystic carcinoma (ACC) of the trachea is one of the most common primary tracheal tumours, second in prevalence only to squamous cell carcinoma (SCC). course of progression is indolent, the oncological characteristics of an ACC predispose these tumours to extensive submucosal and perineural spread. OBJECTIVE We have conducted a systematic review of the literature to assess the current state of surgical resection and reconstructive options in comparison to survival outcomes. METHODS A review of publication on PubMed, Cochrane Library, JBI Library of Systematic Reviews and Ovid databases was undertaken. Searches using the terms “adenoid cystic carcinoma”, “cylindroma”, “trachea” and “tracheobronchial tree” identified all relevant articles in the literature. All articles were reviewed and only those in the English language were included. Journal articles published between 1966 to 2019 were included. RESULTS Using the terms “adenoid cystic carcinoma”, “cylindroma”, “trachea” and “tracheobronchial tree”, 112 and 202 articles were found from Ovid Medline and PubMed respectively. No meta-analyses were found in the Cochrane Library. JBI Library of systematic reviews revealed no systematic reviews. Following removal of duplicated studies, identification of English only studies and an assessment of relevance, a total of 247 were included in the study. CONCLUSIONS Tracheal ACC is a difficult disease to manage and treatment, due to its late presentation and significant associated morbidity. It is a rare primary tracheal malignancy that often presents with no specific symptoms last for weeks to years. It is commonly misdiagnosed as other primary respiratory issues. Complete surgical resection will give the patient the best chance of survival or even cure.