Results and prognostic factors in resections of primary tracheal tumors: A multicenter retrospective study

Abstract

To determine long-term survival and prognostic factors, 208 patients with primary tracheal tumors were evaluated in a retrospective multicenter study including 26 centers. Ninety-four patients had squamous cell carcinoma, four had adenocarcinoma, 65 had adenoid cystic carcinoma, and 45 patients had miscellaneous tumors. The following resections were performed: tracheal resection with primary anastomosis, 165; carinal resection, 24; and laryngotracheal resection, 19. Postoperative mortality rate was 10.5% and correlated with the length of the resection, the need for a laryngeal release, the type of resection, and the histologic type of the cancer. Fifty-nine percent of patients with tracheal cancer and 43% of patients with adenoid cystic carcinomas had postoperative radiotherapy. The 5- and 10-year survivals, respectively, were 73% and 57% for adenoid cystic carcinomas and 47% and 36% for tracheal cancers (p < 0.05). Among patients with tracheal cancers, survival was significantly longer for those with complete resections than for those with incomplete resections. On the other hand, the presence of positive lymph nodes did not seem to decrease survival. Postoperative radiotherapy increased survival only in the case of incompletely resected tracheal cancers. Long-term prognosis was worsened by the occurrence of second primary malignancies in patients with tracheal cancers and by the occurrence of late pulmonary metastases in patients with adenoid cystic carcinomas.

Primary tracheal tumours: 21 years of experience at Peking Union Medical College, Beijing, China

“…The mean duration of symptoms prior to diagnosis has been shown to be four months in general and 12 months for adenoid cystic carcinoma. 5 Tracheal cancer comprises adenoid cystic carcinoma in 25.7-40 per cent of cases and SCC in 25.7 -45.2 per cent of cases. 2,3,5 The remaining histological types are varied and include squamous papilloma, carcinoid tumours, mucoepidermoid tumours, and a variety of carcinomas and sarcomas.…”

“…5 Tracheal cancer comprises adenoid cystic carcinoma in 25.7-40 per cent of cases and SCC in 25.7 -45.2 per cent of cases. 2,3,5 The remaining histological types are varied and include squamous papilloma, carcinoid tumours, mucoepidermoid tumours, and a variety of carcinomas and sarcomas. 7 Three treatment modalities have been applied to tracheal tumours: tracheal resection, endoscopic resection and radiotherapy.…”

“…3,5,6,8 Furthermore, post-operative radiotherapy has been suggested to increase survival only in incompletely resected tumours. 5 The likelihood of survival has been shown to be improved in cases with complete resection. 5,6 Gaissert et al 6 found mean survival rates of 38 months in resected SCC cases and 8.8 months in unresectable SCC cases.…”

“…5 The likelihood of survival has been shown to be improved in cases with complete resection. 5,6 Gaissert et al 6 found mean survival rates of 38 months in resected SCC cases and 8.8 months in unresectable SCC cases. For adenoid cystic carcinoma cases, the mean survival rates were 69 months for resected cases and 41 months for unresectable cases.…”

Tracheal surgery

“…Long-term results of worldwide major experiences of surgery for tracheal tumours are reported in table 3 suggesting a more favourable prognosis for resectable tumours [36,[38][39][40].…”