Abstract

ROSENBERG, Moisés et al. Tracheal primary Tumours. Rev. amer. med. respiratoria [online]. 2013, vol.13, n.1, pp.19-25. ISSN 1852-236X.

Background: Primary tracheal tumors are infrequent and their successful treatment depends on the selection of patients and precise surgical indications. The aim of this paper was to evaluate the histopathology and surgical factors that may influence survival in a series of patients with tracheal tumors that underwent surgery, endoscopic resection, prosthesis, and oncologic treatment. Methods: We revised the records of 54 patients with the diagnosis of tracheal tumors from January 1971 through June 2011. A report on sixteen of these patients was published previously. The following features were taken into account: age, histological type of the tumor, extent of resection of the involved trachea and the presence of remaining disease in the margins. The log Rank test and Kaplan Meier curves were used for survival analysis. Data were expressed as median, ranges, CI 95% and percentages. Multivariate analysis was not performed due to the small number of cases per group. Results: The series consisted of 54 patients, 22 men (41%) and 32 women (59%) . The median age was 50 years. The commonest histological type was adenocystic carcinoma (41%) followed by squamous cell carcinoma (19 %,) carcinoid tumors (7.4%) adenocarcinoma (7.4%), mucoepidermoid carcinoma (6%) and fibrosarcoma (6%). The remaining tumors were benign lesions (13.2%). The median follow up was 2 years, (range 1-26 years). Analyzing separately adenocystic carcinomas (22) and squamous cell carcinomas (10), we found that age older than 50 years (HR 3.27, 95% CI 1.24-8.67, p = 0.017), diagnosis of squamous cell carcinoma (HR 12.29, 95 % 3.18-47.49, p = 0.00), the presence of tumor in the margins (HR 5.78, 95% CI 1.42-23.64, p = 0.015), and resections greater than 6 cm (HR 11.86, 95% CI 3.31-42.44 p = 0.00) were significantly associated with shorter survival time. Conclusion: This larger series of cases confirm, and extend the conclusions of our previous report. We found that in both, adenocystic carcinoma (ACC) and squamous cell carcinoma (SCC), the age, the presence of tumor in the resection margins, and the extent of resection (more than 6 cm) were significantly associated with a poorer prognosis and shorter survival time.

Keywords : Primary Tracheal Tumors; Surgery.

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