Tracheo-bronchial adenoid cystic carcinoma: A retrospective study

Asia Pac J Clin Oncol. 2019 Aug;15(4):244-249. doi: 10.1111/ajco.13162. Epub 2019 May 20.

Abstract

Objectives: Adenoid cystic carcinoma (ACC) of the trachea and bronchus is rare, representing 1% of all respiratory tract cancers. We presented our experiences in treating tracheal-bronchial ACC and the results of long-term surveillance.

Methods: We conducted a retrospective study of treating tracheo-bronchial ACC. From 2009 to 2014, 42 patients presented to our department. All of them received surgical resection and adjunctive therapy.

Results: R0 resections were achieved in 33 patients, whereas 15 patients whose lesions spread outside the tracheo-bronchial lumens. Nine patients had R1 resections followed by radiation and chemotherapy. The 5 year survival rate of R1 resection group showed no difference compared to the R0 resection group, but the 5 year disease-free survival rate showed difference in extra-lumenal invasion (ELI) and non-ELI group (P = 0.0357 < 0.05), although no difference was seen in the overall survival rate in these two groups.

Conclusions: ACC of the trachea and bronchus is a rare and low-to-moderate grade malignant tumor. When the R0 resection is over risky or may cause mortal complication, the R1 resection with adjunctive therapy is acceptable for patients to obtain a promising prognosis, whereas pathological ELI is an adverse prognostic indicator.

Keywords: ACC; R1 resection; adenoid cystic carcinoma; extra-lumenal invasion (ELI); survival rate; tracheal-bronchial.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Adenoid Cystic / diagnosis*
  • Carcinoma, Adenoid Cystic / mortality
  • Carcinoma, Adenoid Cystic / pathology
  • Carcinoma, Adenoid Cystic / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Tracheal Neoplasms / diagnosis*
  • Tracheal Neoplasms / mortality
  • Tracheal Neoplasms / pathology
  • Tracheal Neoplasms / surgery*
  • Young Adult