title: Primary tracheal adenoid cystic carcinoma: adjuvant treatment outcome.
abstract: BACKGROUND
  Adenoid cystic carcinoma (ACC) is the second most common tracheal tumor, but its optimal treatment strategy is still controversial.
  
  
  METHODS
  To further elucidate the impact of treatment on disease-free survival (DFS) and overall survival (OS), we retrospectively investigated different treatment modalities and outcomes of 56 patients with primary ACC of the trachea treated at four hospitals in Sichuan Province of China from 1995 to 2012.
  
  
  RESULTS
  52 patients were included in the analysis. 4 patients with unresectable tumors were treated primarily with radiotherapy (RT) alone. 11 of 48 patients who received surgery as primary therapy obtained complete resection without adjuvant therapy. 24 of 37 patients who had incomplete resection (R1, R2) received postoperative RT while 13 patients were treated without postoperative RT. Postoperative chemotherapy (CT) was used in 12 patients with postoperative RT. No significant difference was shown in DFS (p = 0.683) and OS (p = 0.829) between patients with complete resection and those with incomplete resection. Postoperative RT for patients with incomplete resection was associated with improved DFS (92 vs. 62 months, p = 0.027) and OS (125 vs. 78 months, p = 0.004). Postoperative chemotherapy (CT) following RT did not have a significant impact on DFS (p = 0.390) or OS (p = 0.646) in patients with positive margin.
  
  
  CONCLUSIONS
  These observations suggest that postoperative RT should probably be recommended for patients with incomplete resection. Postoperative CT following RT in patients with incomplete resection did not seem to produce an additional survival benefit.
authors.affiliation: Department of Thoracic Oncology, Cancer Center, West China Hospital, Medical School, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, China.
authors.forename: Furong
authors.initials: F
authors.lastname: Chen
authors.forename: Meijuan
authors.initials: M
authors.lastname: Huang
authors.forename: Yong
authors.initials: Y
authors.lastname: Xu
authors.forename: Tao
authors.initials: T
authors.lastname: Li
authors.forename: Ke
authors.initials: K
authors.lastname: Xie
authors.forename: Ling
authors.initials: L
authors.lastname: Zhang
authors.forename: Deyun
authors.initials: D
authors.lastname: Cheng
authors.forename: Lunxu
authors.initials: L
authors.lastname: Liu
authors.forename: Guowei
authors.initials: G
authors.lastname: Che
authors.forename: Mei
authors.initials: M
authors.lastname: Hou
authors.forename: Jin
authors.initials: J
authors.lastname: Wang
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Luo
authors.forename: You
authors.initials: Y
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003528:Carcinoma, Adenoid Cystic / Q000601:surgery / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016019:Survival Analysis; D014134:Tracheal Neoplasms / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult