[Surgery for primary adenoid cystic carcinoma of cervical trachea].
OBJECTIVE
There were few reports about surgery for primary adenoid cystic carcinoma of cervical trachea. This study was designed to evaluate the efficacy of surgical resection of a series of 13 patients with primary adenoid cystic carcinoma of cervical trachea.


METHODS
Thirteen patients who underwent surgical resection with biopsy-proven primary adenoid cystic carcinoma of cervical trachea were reviewed retrospectively.


RESULTS
Of 13 patients, 6 patients showed that tracheal invasion were more than 40 mm length, 7 less than 40 mm length. Seven patients showed extratracheal invasion, 2 showed distance metastases, and 1 showed metastases in regional lymph nodes. Nine patients were treated with sleeve resection of trachea with primary anastomosis (average length of 34.8 mm resected), of which 3 underwent laryngeal release and 8 reserved laryngeal function; 2 received laryngectomy with end tracheostomy and 2 received partial tracheal resection and a patch of autologous tissue reconstruction. Of 13 patients, 4 patients were treated with complete resection and 9 with incomplete resection alone or combined by postoperative irradiation. No death occurred during operation. Two tracheal stenoses and 1 laryngeal recurrent nerve palsy after operation were observed. Seven patients died after therapy, of which 6 patients failed to local management, 1 case died of distance metastases. The total 5- and 10-year survival rates were 69.2% (9/13) and 50.0% (5/10), respectively. The 5- and 10-year survival rates were 75.0% (3/4) and 75.0% (3/4) for complete resection group, 55.0% (5/9) and 33.0% (2/6) for incomplete resection group, 83.3% (5/6) and 83.3% (5/6) for non-extratracheal invasion group, 57.1% (4/7) and 0% for extratracheal invasion group (P=0.001).


CONCLUSIONS
Sleeve resection of trachea with primary reconstruction is the major treatment of the patients suffering from primary cervical tracheal adenoid cystic carcinoma with the long-term survival and function reservation.
Huang
Wen-Xi
WX
Department of Head and Neck Surgery, Guangzhou Tumor Hospital, Guangzhou, Guangdong, 510095, PR China. wenxin@pub.guangzhou.gd.cn
Xu
Zhen-Gang
ZG
Tang
Ping-Zhang
PZ
Qi
Yong-Fa
YF
Chen
Wei-Quan
WQ
D000328:Adult; D000368:Aged; D003528:Carcinoma, Adenoid Cystic / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007825:Laryngectomy / Q000009:adverse effects / Q000379:methods; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D015996:Survival Rate; D014134:Tracheal Neoplasms / Q000473:pathology / Q000601:surgery*; D014135:Tracheal Stenosis / Q000209:etiology; D014140:Tracheotomy / Q000009:adverse effects / Q000379:methods*