Prommegger R, Salzer G M
Department of Thoracic Surgery, University of Innsbruck, Austria.
Eur J Surg Oncol. 1998 Oct;24(5):440-4. doi: 10.1016/s0748-7983(98)92465-9.
Over a period of 26 years, 16 patients (9 women, 7 men) underwent surgery for primary adenoid cystic carcinoma (ACC) of the trachea and bronchi. The median age at diagnosis was 41.4 years (range 25-67). Nine tumours were located in the bifurcational area, five in the trachea, one in the middle-lobe bronchus and one in the parenchyma of the left lower lobe.
Surgical procedures were as follows: three tracheal transversal resections; five resections of the distal trachea including the bifurcational region, followed by bifurcational reconstruction; two right-sleeve pneumonectomies; three left-sleeve pneumonectomies; two lobectomies; and one explorative sternotomy.
Eleven patients were available for follow-up at least 5 years after surgery. Three of these patients (27%) had local recurrence 155+/-30 (range 120-175) months after surgery. Distant metastases occurred in six patients (55%) after a median time interval of 96+/-68 (range 24-180) months after surgery.
Five-year and 10-year survivals were excellent, 79 and 57% respectively, but the long-term outcome was poor due to late local recurrences and late metastatic spread. It is not yet certain whether a cure can really be achieved in ACC.
在26年的时间里，16例患者（9例女性，7例男性）接受了气管和支气管原发性腺样囊性癌（ACC）的手术治疗。诊断时的中位年龄为41.4岁（范围25 - 67岁）。9个肿瘤位于分叉区，5个位于气管，1个位于中叶支气管，1个位于左下叶实质。
手术方式如下：3例气管横断切除术；5例包括分叉区的远端气管切除术，随后进行分叉重建；2例右肺袖式切除术；3例左肺袖式切除术；2例肺叶切除术；1例探查性胸骨切开术。
11例患者术后至少随访5年。其中3例患者（27%）在术后155±30（范围120 - 175）个月出现局部复发。6例患者（55%）在术后中位时间间隔96±68（范围24 - 180）个月后发生远处转移。
5年和10年生存率分别为79%和57%，效果良好，但由于局部复发晚和远处转移晚，长期预后较差。腺样囊性癌是否真的能治愈尚未确定。
