Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.
Ann Otol Rhinol Laryngol. 2022 Jan;131(1):78-85. doi: 10.1177/00034894211008101. Epub 2021 Apr 19.
Primary tracheal malignancies are relatively rare cancers, representing 0.1% to 0.4% of all malignancies. Adenoid cystic carcinoma (ACC) is the second most common histology of primary tracheal malignancy, after squamous cell carcinoma. This study aims to analyze demographic characteristics and potential influencing factors on survival of tracheal ACC (TACC).
This was a retrospective cohort study utilizing the National Cancer Database (NCDB). The NCDB was queried for all cases of TACC diagnosed from 2004 to 2016 (n = 394). Kaplan-Meier (KM) and Cox proportional-hazards models were used to determine clinicopathological and treatment factors associated with survival outcomes.
Median age of diagnosis was 56 (IQR: 44.75-66.00). Females were affected slightly more than males (53.8% vs 46.2%). The most prevalent tumor diameter range was 20 to 39 mm (34.8%) followed by greater than 40 mm in diameter (17.8%). Median overall survival (OS) was 9.72 years with a 5- and 10-year OS of 70% and 47.5%, respectively. Localized disease was not associated with a survival benefit over invasive disease ( = .388). The most common intervention was surgery combined with radiation therapy (RT) at 46.2%, followed by surgery alone (16.8%), and standalone RT (8.9%). When adjusting for confounders, surgical resection was independently associated with improved OS (HR 0.461, 95% CI 0.225-0.946). Tumor size greater than 40 mm was independently associated with worse OS (HR 2.808; 95% CI 1.096-7.194).
Our data suggests that surgical resection, possibly in conjunction with radiation therapy, is associated with improved survival, and tumor larger than 40 mm are associated with worse survival.
原发性气管恶性肿瘤较为罕见，占所有恶性肿瘤的 0.1%至 0.4%。腺样囊性癌（ACC）是继鳞状细胞癌之后第二常见的原发性气管恶性肿瘤组织学类型。本研究旨在分析气管腺样囊性癌（TACC）的人口统计学特征和潜在的生存影响因素。
这是一项利用国家癌症数据库（NCDB）进行的回顾性队列研究。从 2004 年至 2016 年，对诊断为 TACC 的所有病例（n=394）进行了 NCDB 检索。使用 Kaplan-Meier（KM）和 Cox 比例风险模型确定与生存结果相关的临床病理和治疗因素。
中位诊断年龄为 56 岁（IQR：44.75-66.00）。女性略多于男性（53.8%比 46.2%）。最常见的肿瘤直径范围为 20 至 39mm（34.8%），其次是直径大于 40mm（17.8%）。中位总生存期（OS）为 9.72 年，5 年和 10 年 OS 分别为 70%和 47.5%。局限性疾病与侵袭性疾病相比并没有生存获益（P=0.388）。最常见的干预措施是手术联合放疗（RT），占 46.2%，其次是单纯手术（16.8%）和单纯 RT（8.9%）。在校正混杂因素后，手术切除与改善 OS 独立相关（HR 0.461，95%CI 0.225-0.946）。肿瘤直径大于 40mm 与 OS 较差独立相关（HR 2.808；95%CI 1.096-7.194）。
我们的数据表明，手术切除，可能结合放疗，与改善生存相关，肿瘤直径大于 40mm 与较差的生存相关。
