Ning Ye, He Wenxin, Bian Dongliang, Xie Dong, Jiang Gening
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Asia Pac J Clin Oncol. 2019 Aug;15(4):244-249. doi: 10.1111/ajco.13162. Epub 2019 May 20.
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.
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.
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.
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.
气管支气管腺样囊性癌（ACC）较为罕见，占所有呼吸道癌症的1%。我们介绍了治疗气管支气管ACC的经验以及长期监测结果。
我们对治疗气管支气管ACC进行了一项回顾性研究。2009年至2014年，42例患者到我科就诊。他们均接受了手术切除及辅助治疗。
33例患者实现了R0切除，而15例患者的病变蔓延至气管支气管腔外。9例患者进行了R1切除，随后接受放疗和化疗。R1切除组的5年生存率与R0切除组相比无差异，但5年无病生存率在腔外侵犯（ELI）组和非ELI组之间存在差异（P = 0.0357 < 0.05），尽管两组的总生存率无差异。
气管支气管ACC是一种罕见的低至中度恶性肿瘤。当R0切除风险过高或可能导致致命并发症时，R1切除联合辅助治疗对患者获得良好预后是可接受的，而病理ELI是不良预后指标。
