National Utilization of Surgery and Outcomes for Primary Tracheal Cancer in the United States

Benissan-Messan, Dathe; Merritt, Robert E.; Bazan, Jose G.; D’Souza, Desmond M.; Abdel‐Rasoul, Mahmoud; Moffatt-Bruce, Susan D.; Kneuertz, Peter J.

doi:10.1016/j.athoracsur.2020.03.048

Cited by 15 publications

(20 citation statements)

References 16 publications

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“…A report from Massachusetts General Hospital found that complete resection and age in SCC was associated with improved survival (9). As for mean age of SCC, a national study reported mean age was 65 years and what Massachusetts General Hospital showed was 61 years (6,9), while the mean age of SCC in our study was 56.8 years which was smaller than those of the other studies. On the other hand, R0 resection rate of SCC in our study (100%) was the highest rate of primary TBTs' studies.…”

Section: Discussioncontrasting

confidence: 79%

“…With regards to oncologic outcomes we showed that OS was no statistically significant among ACC, SCC and other pathological types while many previous studies showed strong difference, especially for SCC (5,6,9,13,14). Comparative survival rates after resection varied between previous studies, with 5-year survival rates of 52% to 100% for ACC and 39% to 53% for SCC (2,6,9,29,30). A retrospective analysis from Massachusetts General Hospital reported that 5-year survival of ACC patients with surgery were 78% which was similar to our study (77.6%) (20).…”

Section: Discussionmentioning

confidence: 55%

“…An interesting result was noticed in our study. With regards to oncologic outcomes we showed that OS was no statistically significant among ACC, SCC and other pathological types while many previous studies showed strong difference, especially for SCC (5,6,9,13,14). Comparative survival rates after resection varied between previous studies, with 5-year survival rates of 52% to 100% for ACC and 39% to 53% for SCC (2,6,9,29,30).…”

Section: Discussionmentioning

confidence: 63%

“…Thirdly, the effect of complete resection on survival remains controversial in primary tracheobronchial neoplasm. Usually, R0 resected is required, and many studies have also proved that R0 resection has a better prognosis than R1 (6). However, several studies indicated that the OS between patients with having complete resection and incomplete resection was not significant (19,27).…”

Section: Discussionmentioning

confidence: 99%

“…Surgical treatment is usually the most important treatment for TBT (2)(3)(4). Survival after diagnosis was significantly longer for patients undergoing curative intent resection, with a median overall survival (OS) of 82-198 months, as compared with 3-92 months for patients who did not undergo surgery (2,(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

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Surgical treatment of primary tracheobronchial tumors: 16-year experience in a single center

Liu¹,

Zheng²,

Lu³

et al. 2022

J Thorac Dis

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Background: Primary tracheobronchial tumor (TBT) is a rare disease, and the prognostic factors of surgical treatment have not been well identified.Methods: Patients with primary TBT and accepted surgical treatment between January 2004 and January 2020 at our institution were retrospectively analyzed. The univariate analysis and multivariate analysis were conducted on the malignant cases. The overall survival (OS) was analyzed using Kaplan-Meier method, and potential prognostic factors were analyzed using Cox regression analysis.Results: A total of 69 patients (29 males and 40 females) were included. The median follow-up duration was 75.7 months (1.2-177.4 months). The most common histology was adenoid cystic carcinoma (ACC) (37.7%) followed by squamous cell carcinoma (SCC) (23.2%). For patients with malignant tumors, the estimated 5-year OS of the overall population was 77.2% and the estimated 5-year OS of SCC patients was 73.8% especially. The univariate Cox regression analysis identified that age and tumor size had significant effects on OS. The multivariate analysis showed that age (≤50 years or >50 years) was independent prognostic factor for OS (P<0.05).Conclusions: Age is independent factor affecting the OS of primary TBT treated by surgery. And patients of TBT with younger age should be much more referred for surgery.

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Section: Discussioncontrasting

confidence: 79%

Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Surgical treatment of primary tracheobronchial tumors: 16-year experience in a single center

Liu¹,

Zheng²,

Lu³

et al. 2022

J Thorac Dis

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Disparities in Survival Due to Social Determinants of Health and Access to Treatment in US Patients With Operable Malignant Pleural Mesothelioma

et al. 2023

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ImportanceOutcomes of localized malignant pleural mesothelioma (MPM) remain poor despite multimodality therapy. It is unclear what role disparities have in the overall survival (OS) of patients with operable MPM.ObjectiveTo examine survival disparities associated with social determinants of health (SDOHs) and treatment access in patients with malignant pleural mesothelioma.Design, Setting, and ParticipantsIn this observational, retrospective cohort study, patients with MPM diagnosed between January 1, 2004, and December 31, 2017, were identified from the National Cancer Database with a maximum follow-up time of 13.6 years. The analysis was conducted from February 16, 2022, to July 29, 2022. Patients were included if they were diagnosed with potentially resectable clinical stage I to IIIA MPM, had epithelioid and biphasic histologic subtypes, and received chemotherapy. Patients were excluded if they could not receive curative surgery, were 75 years or older, or had metastasis, unknown stage, or tumor extension to the chest wall, mediastinal tissues, or organs.ExposuresChemotherapy alone vs chemotherapy with curative surgery in the form of pleurectomy and decortication or extrapleural pneumonectomy.Main Outcomes and MeasuresThe primary end point was OS. Cox proportional hazards regression models were used to determine hazard ratios (HRs) for OS, including univariable and multivariable models controlling for potential confounders, including demographic, comorbidity, clinical, treatment, tumor, and hospital-related variables, as well as SDOHs.ResultsA total of 1389 patients with MPM were identified (median [IQR] age, 66 [61-70] years; 1024 [74%] male; 12 [1%] Asian, 49 [3%] Black, 74 [5%] Hispanic, 1233 [89%] White, and 21 [2%] of other race). The median OS was 1.7 years (95% CI, 1.6-1.8). Risk factors associated with worse OS included older age, male sex, Black race, low income, and low educational attainment. Factors associated with greater odds of survival included receipt of surgical therapy, recent year of treatment, increased distance to travel, and treatment at high-volume academic hospitals. The risk factors most strongly associated with poor OS included Black race (HR, 1.96; 95% CI, 1.43-2.69) and male sex (HR, 1.60; 95% CI, 1.38-1.86). Surgical treatment in addition to systemic chemotherapy (HR, 0.70; 95% CI, 0.61-0.81) was independently associated with improved OS, as were chemotherapy initiation (HR, 0.93; 95% CI, 0.87-0.99) and greater travel distance from the hospital (HR, 0.92; 95% CI, 0.86-0.98).Conclusions and RelevanceIn this retrospective cohort study of patients with operable MPM, there was significant variability in access to care by SDOHs. Addressing disparities in access to multimodality therapy can help ensure equity of care for patients with MPM.

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Outcomes and predictors of survival for tracheal cancer

Desai,

Zambetti,

Wong

et al. 2023

Journal of Surgical Oncology

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IntroductionPrimary tracheal cancer is uncommon, with poor survival. While surgical resection is the mainstay of therapy, the role of chemotherapy and radiation is poorly defined. We aimed to study the impact of treatment modalities on survival.MethodsPatients with primary tracheal cancer were identified from the National Cancer Database over 12 years, 2004–2015. Patient characteristics, tumor characteristics, treatment modalities, and survival were recorded. Factors associated with survival were assessed using Cox Regression.ResultsOf the 1726 patients identified, 59% were male, 83% White race, 62% had a comorbidity index of zero, median age 64 years, median tumor size 2.7 cm, and median survival was 28.5 months (89 months for patients undergoing surgical resection). Cox Regression for all patients found adenoid cystic carcinoma (ACC) (p < 0.001), radiation (p < 0.001), and surgical resection (p < 0.001) to be associated with improved survival, while increasing age (p < 0.001) decreased survival. For patients receiving resection, ACC (p < 0.001) was associated with improved survival, while increasing age (p < 0.001) and positive margins (p = 0.002) were associated with worse survival. For R0 resections, ACC (p < 0.001) was associated with improved survival, while increasing age (p < 0.001) decreased survival, with chemotherapy and radiation having no impact. For R1/2 resections, ACC (p < 0.001) and radiation (p < 0.001) were associated with improved survival, while increasing age (p < 0.001) decreased survival, with chemotherapy having no impact on survival.ConclusionsPrimary tracheal cancer is highly lethal, with surgical resection leading to the best chance of survival. For patients undergoing resection, radiation provided survival benefits for R1/2 but not R0, while chemotherapy did not impact survival regardless of margin status.

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National Utilization of Surgery and Outcomes for Primary Tracheal Cancer in the United States

Cited by 15 publications

References 16 publications

Surgical treatment of primary tracheobronchial tumors: 16-year experience in a single center

Surgical treatment of primary tracheobronchial tumors: 16-year experience in a single center

Disparities in Survival Due to Social Determinants of Health and Access to Treatment in US Patients With Operable Malignant Pleural Mesothelioma

Outcomes and predictors of survival for tracheal cancer

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