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Treatment for Patients with Primary Tracheal Tumors

Abstract: ObjectiveTo explore the surgical characteristics of primary tracheal tumors treatment and its prognosis. Methods [WTBZ]We retrospectively investigated the clinical records of 38 patients with primary tracheal tumors in both Xiangya Hospital of Central South University and Hunan Provincial Tumor Hospital from Febuary 1982 to August 2009. There were 24 males and 14 females aged from 7 to 65 years. There were 2 benign lesions, 13 adenoid cystic carcinomas, 11 squamous cell carcinomas, 5 mucoepidermoid carcinomas, 4 adenocarcinomas and 3 other cell types. One patient with adenocarcinoma underwent exploratory thoracotomy only; 33 patients underwent tracheal resection and airway reconstruction, and according to the tumor growth characteristics, the surgeon applied circumferential tracheal resection with endtoend anostomosis or wedge resection; One patient had papilloma resected under fiber bronchoscopy; and three patients with locally advanced lesions underwent radiotherapy without surgery. The overall survival rate was calculated by the KaplanMeier method. The logrank method was used for comparing survival rates among different groups, characterized by cell types or surgical procedures. Results [WTBZ]The patient with exploratory thoracotomy died 3 days after surgery from respiratory failure. The perioperative mortality was 2.94% (1/34), and all the remaining 33 patients recovered and were discharged from hospital. Minor complications happened to 12 patients (35.29%), including 6 patients with pulmonary infection, 4 with atelectasis, and 2 with hoarseness. The followup time ranged from 6 months to 15 years. The followup rate was 97.29% (36/37). The threeunresected patients died within 6 months after hospital discharge. The 1, 5, and 10year survival rate for resected patients was88% （95%CI 0.77 to 0.99), 47%(95%CI 0.29 to 0.66), and 41% (95%CI 0.21 to 0.61), respectively. The survival rate of adenoid cystic carcinoma or mucoepidermoid carcinoma was significantly higher than that of squamous cell carcinoma or other tissue types (χ2=17.581, P=0.001). There was no statistical difference (χ2=0.021, P=0.886) in 5 year survival rate between wedge resection group at 63%(95%CI 0.34 to 0.91) and the segmental resection group at 77%(95%CI 0.44 to 0.99). Conclusions [WTBZ]Surgical treatment is safe and beneficial for primary tracheal tumors, and the pathological type is a significant prognostic factor after complete resection.